2019-10-22T11:38:36-05:00 2018-12-31 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2018-01-01 930933975 CAREOREGON INC % Teresa Kennedy Learn CFO CARE 5034164100 315 SW 5TH AVE PORTLAND OR 97204 TERESA KENNEDY LEARN CFO 5034161415 2019-10-17 true LISA M MEYER P01490170 2069134000 2019-10-08 167.68.102.5 91023620192955000001 2019-10-22 P E616D976C076AC6BCB48D2C3315D43698568006E 67FC745ED92A135AFB39684C7B69FAB2C5F30E78 2018 2020-01-14 16:20:31Z Eric Hunter 315 SW 5TH AVE PORTLAND OR 97204 1265449107 false X WWW.CAREOREGON.ORG X 1994 OR CareOregon is a non-profit Health Plan whose mission is building individual well-being and community health through shared learning and innovation. 14 13 1007 147 17516546 474102 287784 824022338 1114298304 24436340 15848863 12275705 17279512 861208485 1147714463 4057806 3118814 0 0 76035386 90068023 0 0 0 821699771 1003887764 901792963 1097074601 -40584478 50639862 417596891 427700632 190643196 175433882 226953695 252266750 X SEE SCHEDULE O true false 1005729226 1080393587 OHP Program - SEE SCHEDULE O FOR DESCRIPTION 18191580 19206680 Medicare Plan - SEE SCHEDULE O FOR DESCRIPTION 3118814 3118814 Charitable Contributions - SEE SCHEDULE O FOR DESCRIPTION 12217893 14698037 1039257513 true true false true false false false false false false true true false true true false false true false false false false false false false false false true false true false false false false false false false false false false false false true true true true false false true 2508 0 true 1007 true true true false false false false false false false false false false false X 14 13 false false false false false false false true true false false true true true true true true true true true true OR X Teresa Kennedy Learn CFO 5034161415 315 SW 5th Avenue Portland OR 97204 X GLENN S RODRIQUEZ BOARD CHAIRMAN 4.0 1.25 X X 0 0 0 SUSAN M HENNESSY BOARD VICE CHAIRMAN 4.0 1.25 X X 0 0 0 VICKIE S GATES BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 BETH A DEHAMEL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 JOANNE FULLER BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 DAMIEN R HALL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 BRENDA I JOHNSON BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 NATHALIE JOHNSON BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 HYOSUK RHEE BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 ROBERT C STEWART BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 TAEKYUNG HAN BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 GINA F NIKKEL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 WOODRUFF J ENGLISH II BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 ERIC C HUNTER CEO, PRESIDENT & BOARD OF DIRE 32.17 7.83 X X 467177 0 33019 TERESA K LEARN CFO, BOARD TREASURER 30.75 9.25 X 272031 0 33325 AMIT R SHAH CHIEF MEDICAL OFFICER 31.33 8.67 X 349789 0 24009 ERIN D FAIR CLO, BOARD SECRETARY 32.16 7.84 X 231111 0 25633 GREGORY P MORGAN CHIEF OPERATIONS OFFICER 32.37 7.73 X 212994 0 29774 KATHERINE A ELLIS COO, BOARD SECRETARY 32.51 7.49 X 136855 0 7695 REBECCA RAMSAY VP, HOUSECALL PROVIDERS 19.93 20.07 X 228119 0 46507 NATHAN CORLEY VP, INFO SVCS & ANALYTICS 31.63 8.37 X 202722 0 26785 DOUGLAS R LUTHER SR. MED DIRECTOR, OPERATIONS 32.4 7.6 X 304472 0 25576 WILLIAM J KENNEDY SR. MED DIRECTOR, ADVANCED ILL 14.17 25.83 X 278919 0 47658 CARL D STEVENS MEDICAL DIRECTOR 36.07 3.93 X 266980 0 32228 ALYSSA FRANZEN VICE PRESIDENT, DENTAL 40.0 0.0 X 225158 0 32432 SAFINA KOREISHI MEDICAL DIRECTOR 40.0 0.0 X 230388 0 26273 3406715 0 390914 132 false true false GSI HEALTH LLC 1735 MARKET ST 53RD FLOOR PHILADELPHIA PA 19103 HEALTH MGMT PLATFORM 1518650 HEALTHTRIO LLC 400 S COLORADO BLVD SUITE 540 DENVER CO 80246 ADMINISTRATIVE 671826 RED CARD SYSTEMS LLC 744 OFFICE PARKWAY SAINT LOUIS MO 63141 CLAIMS PROCESSING 365423 KPMG LLP PO BOX 120922 DEPT 0922 DALLAS TX 75312 AUDIT/TAX SERVICES 361858 CDW DIRECT LLC PO BOX 75723 CHICAGO IL 60675 COMPUTER/MAINT/FEES 287195 17 114924 172860 287784 Premium Revenue 524114 1080393587 1080393587 Management Fee 541611 27062499 19933179 7129320 Training & Consulting Revenue 611430 287133 259943 27190 Patient Revenue 621610 5113117 5113117 ALL OTHER PROGRAM SERVICE REVENUE 900099 1441968 1231065 210903 1114298304 6796207 6796207 0 0 407414 182394 225020 0 225020 225020 126604906 117552250 9052656 9052656 9052656 0 0 0 0 0 0 0 0 0 Employee Lease Revenue 541611 17054492 6905359 10149133 17054492 1147714463 1113836250 17516546 16073883 3118814 3118814 0 0 0 2327546 274626 2052920 0 0 69050984 46221577 22829407 0 4245885 2758937 1486948 8964187 6478516 2485671 5479421 3535499 1943922 0 281940 281940 288148 288148 25000 25000 0 690833 690833 8667493 4335107 4332386 196676 147319 49357 1991746 1425511 566235 6904725 108404 6796321 0 1760316 2760 1757556 567261 391724 175537 0 350373 126385 223988 -50337 -50337 0 0 4064464 4064464 253677 253677 Physical healthcare expense 894306616 894306616 Dental healthcare expense 32668694 32668694 Mental healthcare expense 41858314 41858314 All other expenses 9061825 1498710 7563115 1097074601 1039257513 57817088 0 52000 31157 46894590 78938759 159131 0 36539342 20948538 0 0 0 0 1196450 926227 343 6041 3922929 5216083 47247736 27908025 21196501 19339711 229806481 264626481 73317654 0 0 0 0 0 4511470 37667635 417596891 427700632 23047249 21057303 0 0 368153 242524 0 0 0 0 0 0 0 0 0 0 167227794 154134055 190643196 175433882 X 226853465 252237842 100230 28908 0 0 226953695 252266750 417596891 427700632 X 50639862 -17829023 1181 -7498965 X false true X true false X 1676151 1144558 339602 474102 287784 3922197 832133142 918922129 862474890 816414092 1106930891 4536875144 0 0 0 833809293 920066687 862814492 816888194 1107218675 4540797341 0 0 0 4540797341 4841109 6384386 6830965 7332802 7203621 32592883 0 4841109 6384386 6830965 7332802 7203621 32592883 865461 865461 0 838650402 926451073 869645457 824220996 1115287757 4574255685 0.99269 0.99270 0.00713 0.00730 X 22897 157853 180750 1096893851 1097074601 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 115147 92888 266623 180750 655408 250000 250000 250000 250000 1000000 1500000 18676 22897 41573 Part II-A, Line 1 CareOregon participates in lobbying activities that include testifying at public policy hearings, and meeting with legislators to discuss Oregon Health Plan related issues. CareOregon does not participate in or contribute to political candidate campaigns or political parties. false false 2704520 2704520 22090628 10163710 11926918 161083 143577 17506 6267821 5528901 738920 16023684 12071837 3951847 19339711 FEDERAL INCOME TAXES 158800 INTERCOMPANY RECEIVABLE 4787854 RISK CORRIDOR RECEIVABLE 3369415 PAY FOR PERF CCO INCENTIVES 29146607 DEPOSITS AND OTHER ASSETS 204959 37667635 0 CLAIMS PAYABLE 103837246 RISK CORRIDOR PAYABLE 353609 MANAGED CARE CONTRACTS PAYABLE 1427448 INTERCOMPANY LIABILITIES 364288 PAY FOR PERF PROVIDER INCENTIVES 42231595 PREMIUM DEFICIENCY RESERVE 4580572 PREMIUM RECOUPMENT PAYABLE 1339297 154134055 X Part X, Line 2 The internal revenue services (IRS) has recognized CareOregon as exempt from federal income taxes under provisions of section 501 (c) (3) of the internal revenue code. The whollly-owned subidiary, Health Plan of CareOregon (Health Plan), is also a 501 (c) (3) tax-exempt nonprofit entity. Health Plan is a Medicare Advantage Plan reported on a separate Form 990. Health Plan has held this status since December 31, 2016. The wholly-owned subsidiaries, Care Access, LLC; Columbia Pacific CCO, LLC; Jackson Care Connect CCO, LLC; Housecall Providers Services, LLC, are single-member limited liability corporations, working to further CareOregon's exempt purpose. All of these LLCS are treated as disregarded entities for federal tax purposes and are reported with the parent's financial results on its Form 990. The organization recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax position will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Organization recognizes interest and penalties related to income tax matters in interest expense and other administrative expenses, respectively. Housecall Providers, PC - Organized in April 2017 as a professional corporation, Housecall Providers, PC (HCP PC) is 51% owned by the Organization's chief medical officer and 49% owned by the Parent. Effective May 31, 2017, through an asset transfer agreement, certain assets and liabilities of Housecall Providers, Inc. related to home-based primary care services were transferred to HCP PC which provides medical care, integrating primary and palliative services for homebound members and provides certain provider services to HCP LLC and the Organization. The assets transferred were primarily net receivables, which exceeded the liabilities. The excess of $1,149,778 was recorded as contributions received. Although the Parent owns the minority interest of HCP PC, they retain ultimate control. Upon the dissolution of HCP PC, its net assets would be distributed to the Parent. For purpose of financial reporting, HCP PC is consolidated as a wholly owned subsidiary. HCP PC applied for its exemption status from federal income tax effective May 31, 2017. Housecall Providers, PC will file a separate Form 990. true ADELANTE MUJERES 2030 MAIN ST STE A FOREST GROVE OR 97116 030473181 501(c)(3) 37000 TRAUMA INFORMED EARLY CHILDHOOD EDUCATION AGE FRIENDLY INNOVATORS PO BOX 688 JACKSONVILLE OR 97530 464029176 501(c)(3) 20000 GRANDMA'S PORCH ASIAN HEALTH AND SERVICE CENTER 9035 SE FOSTER RD PORTLAND OR 97266 931192100 501(c)(3) 11500 ANNUAL HEALTH CONFERENCE BRIDGE MEADOWS 8502 N WAYLAND AVE PORTLAND OR 97203 202028975 501(c)(3) 40000 PREVENTING HOMELESSNESS FOR YOUTH IN FOSTER CARE BRIDGES TO CHANGE INC PO BOX 16576 PORTLAND OR 97292 760751239 501(c)(3) 51000 NEXT STEP HOUSING FOR WOMEN AND CHILDREN CASCADE AIDS PROJECT 520 NW DAVIS ST STE 215 PORTLAND OR 97209 930903383 501(c)(3) 8000 PLEDGE TO PRISM HEALTH FOR ROOM DEDICATION CENTRAL CITY CONCERN 232 NW SIXTH AVENUE PORTLAND OR 97209 930728816 501(c)(3) 512611 HOUSING IS HEALTHCARE PROJECTS CHILDREN FIRST FOR OREGON 1209 SE BELMONT ST PORTLAND OR 97214 943168157 501(c)(3) 10000 UNITED FOR KIDS GUBERNATORIAL FORUM DENTAL 3 7420 SW HUNZIKER STE F PORTLAND OR 97223 472609004 501(c)(3) 53867 CONTRIBUTION FOR PROVIDING DENTAL PREVENTATIVE SERVICES FOR UNINSURED CHILDREN ELEVATE OREGON 12215 NE MARX ST PORTLAND OR 97230 272151955 501(c)(3) 7500 PROVIDE IN SCHOOL MENTORING FOR AT RISK KIDS FRIENDS OF ZENGER FARM 11741 SE FOSTER RD PORTLAND OR 97266 931269630 501(c)(3) 10000 TO IMPROVE HEALTHCARE QUALITY JACKSON COUNTYMEDFORD SCHOOL DISTRICT 549C 815 S OAKDALE AVE MEDFORD OR 97504 936000519 COUNTY 12160 READY FOR KINDER HOME VISITING KAIROS NORTHWEST PO BOX 12190 PORTLAND OR 97212 460987167 501(c)(3) 40000 CULTURALLY RESPONSIVE TRAUMA CARE KIDS UNLIMITED OF OREGON 821 N RIVERSIDE MEDFORD OR 97501 931329922 501(c)(3) 15000 PASS TO PLAY SPORTS LA CLINICA DEL VELLE FAMILY HEALTH CARE CENTER INC 3617 S PACIFIC HIGHWAY MEDFORD OR 97501 943096772 501(c)(3) 488792 PRIMARY CARE INVESTMENT FUND PROGRAM LINES FOR LIFE 5100 SW MACADAM AVE PORTLAND OR 97239 930725294 501(c)(3) 10000 OREGON CONFERENCE LIVING YOGA 5100 SW MACADAM AVE 360 PORTLAND OR 97239 743103432 501(c)(3) 35000 TRAUMA HEALING & RESILIENCY FOR YOUTH LUKE-DORF INC 8915 SW CENTER ST PORTLAND OR 97223 930685734 501(c)(3) 52000 BRIDGEVIEW ENHANCED NURSING PROGRAM MULTNOMAH COUNTY HEALTH DEPARTMENT 421 SW OAK STREET 201 PORTLAND OR 97204 936002309 COUNTY 568275 PCIF FUNDING PROJECT - MCHM TARGET NATIVE AMERICAN YOUTH AND FAMILY CENTER 5135 NE COLUMBIA BLVD PORTLAND OR 97218 931141536 501(c)(3) 10000 NAYA 15TH ANNUAL GALA NATIVES OF ONE WIND INDIGENOUS ALLIANCE 27 N IVY MEDFORD OR 97501 261810916 501(c)(3) 20600 FAMILIAS SANAS HEALTH PROGRAM NORTH BY NORTHEAST COMMUNITY HEALTH CENTER 714 NE ALBERTA ST PORTLAND OR 97211 721618287 501(c)(3) 10000 COMMUNITY SUPPER EVENT OFF THE SIDELINE 2809 SE CLINTON PORTLAND OR 97202 474585067 501(c)(3) 10000 SCHOLARSHIPS TO LOW INCOME CHILDREN TO PLAY SPORTS OREGON PUBLIC HEALTH INSTITUTE 411 NE 19TH AVE BLDG 1 PORTLAND OR 97232 931259522 501(c)(3) 38000 ORCHWA EARLY LIFE PROGRAMS OREGON SCHOOL BASED HEALTH CARE NETWORK 310 SW 4TH AVE STE 905 PORTLAND OR 97204 364588657 501(c)(3) 5750 HEALTH ADVOCACY DAY PARTNERS FOR A HUNGER FREE OREGON 712 SE HAWTHORNE BLVD PORTLAND OR 97214 204970868 501(c)(3) 10000 HUNGER FREE SCHOOLS INITIATIVE RECLAIMING LIVES 228 E MAIN ST STE E MEDFORD OR 97501 824642746 501(c)(3) 10000 RECOVERY CAFE MEDFORD ROGUE RETREAT 1410 W 8TH ST MEDFORD OR 97501 931261999 501(c)(3) 60500 MEDICATION ASSISTED TREATMENT PROGRAM SISKIYOU COMMUNITY HEALTH CENTER 1701 NW HAWTHORNE AVE GRANTS PASS OR 97526 930628804 501(c)(3) 30000 PROJECT BABY CHECK PROGRAM SOUTHERN OREGON CHILD AND FAMILY COUNCIL PO BOX 3697 CENTRAL POINT OR 97502 930564896 501(c)(3) 30000 HEALTH LITERACY TRAINING SOUTHERN OREGON EDUCATION SERVICE DIST 101 N GRAPE ST MEDFORD OR 97501 936008718 STATE 10000 SOUTHERN OREGON SUCCESS PROGRAM SOUTHERN OREGON UNIVERSITY 1250 SISKIYOU BLVD ASHLAND OR 97520 237030910 501(c)(3) 23000 SERVICES FOR LATINO STUDENTS SPARTAN BOXING CLUB 729 WELCH ST MEDFORD OR 97501 463371625 501(c)(3) 30000 PROJECT STEER STORE TO DOOR 7730 SW 31ST ST PORTLAND OR 97208 943105555 501(c)(3) 12500 PROVIDE ASSISTANCE TO THE PROGRAMS AND ACTIVITIES THE LUND REPORT PO BOX 82841 PORTLAND OR 97282 263019179 501(c)(3) 25000 ANNUAL SPONSORSHIP OF OREGON HEALTH FORUM THE SHADOW PROJECT 2154 NE BROADWAY STE 130 PORTLAND OR 97232 651166066 501(c)(3) 25000 EXPANDING TRAUMA FOR STUDENTS WITH DISABILITIES TILLAMOOK COUNTY WOMENS RESOURCE CENTER 1902 2ND ST TILLAMOOK OR 97141 930823216 501(c)(3) 5884 EVIDENCE BASED TRAINING FOR YOUTH TRANSITION PROJECTS 665 NW HOYT ST PORTLAND OR 97209 930591582 501(c)(3) 50000 TRANSITION PROJECT WELLNESS ACCESS SPECIALIST UNITED WAY OF JACKSON COUNTY INC 1457 E MCANDRES RD C MEDFORD OR 97504 930576632 501(c)(3) 5500 COMMUNITY EFFORTS TO SUPPORT MEDICAID VIRGINIA GARCIA MEMORIAL HEALTH CENTER PO BOX 568 CORNELIUS OR 97113 930717997 501(c)(3) 474203 PRIMARY CARE INVESTMENT FUND PROJECT VIRGINIA GARCIA MEMORIAL FOUNDATION PO BOX 6149 ALOHA OR 97007 912077840 501(c)(3) 49000 SERVING MUSLIM REFUGEE FAMILIES WILDWOOD PLAYGROUNDS NW 2127 NE 10TH AVE PORTLAND OR 97212 470916977 13954 PLAY AND PARK DISCOVERY CAVE 41 1 PART I, LINE 2 Grants and other assistance are provided to organizations in our service area who demonstrate a financial need in regard to improving the delivery of health services in line with our exempt purpose and mission. CareOregon considers each case to verify that the need is documented, legitimate and substantial in nature. Following disbursement of funds, follow-up contact is performed, either verbally or in writing, to verify the appropriate use of the funds, to the extent possible. X true true X X X X false false false false false false false false false ERIC C HUNTER CEO, PRESIDENT & BOARD OF DIRE 415819 50938 420 19150 13869 500196 TERESA K LEARN CFO, BOARD TREASURER 257297 14734 0 18637 14688 305356 AMIT R SHAH CHIEF MEDICAL OFFICER 332552 15737 1500 19150 4859 373798 ERIN D FAIR CLO, BOARD SECRETARY 221882 7729 1500 15459 10174 256744 GREGORY P MORGAN CHIEF OPERATIONS OFFICER 198019 7687 7288 12762 17012 242768 DOUGLAS R LUTHER SR. MED DIRECTOR, OPERATIONS 290036 12645 1791 19033 6543 330048 WILLIAM J KENNEDY SR. MED DIRECTOR, ADVANCED ILL 268437 9902 580 18236 29422 326577 CARL D STEVENS MEDICAL DIRECTOR 260253 6427 300 17364 14864 299208 ALYSSA FRANZEN VICE PRESIDENT, DENTAL 216520 8023 615 15652 16780 257590 SAFINA KOREISHI MEDICAL DIRECTOR 215436 5637 9315 15988 10285 256661 REBECCA RAMSAY VP, HOUSECALL PROVIDERS 219876 7943 300 16228 30279 274626 NATHAN CORLEY VP, INFO SVCS & ANALYTICS 195803 6919 0 13978 12807 229507 PART I, LINE 1A CAREOREGON REIMBURSED HEALTH CLUB DUES FOR ERIC HUNTER, DOUGLAS LUTHER, WILLIAM KENNEDY, ALYSSA FRANZEN AND SAFINA KOREISHI IN THE AMOUNT OF $420, $291, $280, $401, AND $315 RESPECTIVELY. THIS REIMBURSEMENT WAS INCLUDED AS TAXABLE COMPENSATION TO THESE PARTIES. SUPPLEMENTAL INFORMATION TO 2018 FORM 990 FOR CAREOREGON, INC. PART III, LINE 1 TAX-EXEMPT PURPOSE AND MISSION OF CAREOREGON CAREOREGON IS A NONPROFIT HEALTH PLAN ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATION AND SCIENTIFIC PURPOSES. IT CONTRACTS WITH SEVERAL COORDINATED CARE ORGANIZATIONS (CCOS) AND WITH THE OREGON HEALTH AUTHORITY (OHA) TO MANAGE CARE AND PROVIDE HEALTH CARE SERVICES TO MEDICAID ENROLLEES. BY LISTENING TO OUR MEMBERS AND EXPLORING INNOVATIVE SOLUTIONS WITH OUR PROVIDERS AND COMMUNITIES, WE HELP OREGONIANS PREVENT ILLNESS AND LIVE BETTER LIVES. EVERY DAY, WE STRENGTHEN OUR COMMUNITIES BY MAKING HEALTH CARE WORK FOR EVERYONE. WE PROVIDE MANAGED CARE SERVICES TO APPROXIMATELY 255,000 OREGON HEALTH PLAN (MEDICAID) MEMBERS THROUGH OUR PARTNERSHIPS WITH THREE COORDINATED CARE ORGANIZATIONS, AND TO APPROXIMATELY 13,000 MEDICARE MEMBERS. OUR MEMBERS ARE LOCATED IN THE PORTLAND METROPOLITAN AREA, SOUTHERN OREGON AND THE NORTHERN OREGON COASTAL COUNTIES. . TWO OF OUR CCOS ARE LIMITED LIABILITY CORPORATIONS (LLCS) OWNED BY CAREOREGON: JACKSON COUNTY CCO, LLC (JACKSON CARE CONNECT), IN JACKSON COUNTY; AND COLUMBIA PACIFIC CCO, LLC, IN COLUMBIA, TILLAMOOK AND CLATSOP COUNTIES. . HEALTH SHARE OF OREGON (HEALTH SHARE) IS MADE UP OF FOUR HEALTH PLANS (KAISER PERMANENTE, PROVIDENCE, TUALITY AND CAREOREGON), THREE COUNTY MENTAL HEALTH DEPARTMENTS, AND NINE DENTAL CARE ORGANIZATIONS. CAREOREGON PROVIDES PHYSICAL HEALTH MANAGED CARE SERVICES TO MOST OF HEALTH SHARE'S MEMBERS, AND A PORTION OF HEALTH SHARE'S DENTAL HEALTH MANAGED CARE SERVICES. THIS PARTNERSHIP SERVES OREGON HEALTH PLAN MEMBERS IN MULTNOMAH, CLACKAMAS AND WASHINGTON COUNTIES. HEALTH SHARE IS A SEPARATE CCO UNRELATED TO CAREOREGON THAT ENGAGES CAREOREGON FOR MOST OF ITS ADMINISTRATIVE SERVICES. . YAMHILL COMMUNITY CARE ORGANIZATION IN YAMHILL COUNTY IS A SEPARATE CCO THAT ENGAGES CAREOREGON FOR MOST OF ITS ADMINISTRATIVE SERVICES. . CAREOREGON DENTAL, A LINE OF BUSINESS OF CAREOREGON, PROVIDES DENTAL SERVICES TO MEMBERS OF HEALTH SHARE AND OREGON HEALTH PLAN'S OPEN CARD PROGRAM IN THE PORTLAND METRO REGION. . THE WAY TO WELLVILLE IS A FIVE-YEAR PROJECT SUPPORTED BY CAREOREGON AND COLUMBIA PACIFIC CCO IN CLATSOP COUNTY. IT IS ONE OF FIVE WAY-TO-WELLVILLE PROJECTS CURRENTLY UNDERWAY IN THE U.S., WHICH HELP PROMOTE HEALTH IMPROVEMENT IN THE COMMUNITIES TAKING PART. SCHOOLS, PARKS AND RECREATION, CIVIC GROUPS, POLICE AND FIRE DEPARTMENTS, HEALTH PLANS, HOSPITALS, PROVIDERS AND PRIVATE CITIZENS COLLABORATE ON PROGRAMS THAT IMPROVE WELLNESS. . HOUSECALL PROVIDERS SERVICES, LLC, A MEMBER OF THE CAREOREGON FAMILY, PROVIDES HOME-BASED CARE AND HOSPICE SERVICES. HOUSECALL PROVIDERS, PC, OFFERS MEDICAL CARE, INTEGRATING PRIMARY AND PALLIATIVE SERVICES FOR HOMEBOUND PATIENTS IN THE PORTLAND METRO REGION. . UNDER A CONTRACT WITH OHA, CAREOREGON PROVIDES CARE COORDINATION TO AMERICAN INDIANS AND ALASKA NATIVES ON THE OREGON HEALTH PLAN. THE ORIGINAL REQUEST FOR THIS PROGRAM CAME FROM THE NINE FEDERALLY RECOGNIZED TRIBES IN OREGON BASED ON THE POSITIVE REPUTATION CAREOREGON HAS FOR CARE SUPPORT. THE TRIBES, OHA AND CAREOREGON COLLABORATED ON THE PROGRAM DESIGN. PART III, LINE 2 NEW PROGRAM SERVICES IN 2018, ALL CCOS, INCLUDING THOSE IN THE CAREOREGON FAMILY OF COMPANIES, BEGAN PROVIDING THE OREGON HEALTH PLAN HEALTH CARE SERVICES TO ALL CHILDREN AND TEENS IN THE STATE, REGARDLESS OF IMMIGRATION STATUS UNDER THE COVER-ALL-KIDS PROGRAM. IT INCLUDES PHYSICAL, DENTAL AND BEHAVIORAL HEALTH CARE. ALL COVERED SERVICES ARE FREE. THE PROGRAM LAUNCHED JANUARY 1, 2018, AND CCOS BEGAN PROVIDING THE SERVICES ON MARCH 5, 2018. PART III, LINE 4 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS A. OREGON HEALTH PLAN (MEDICAID) PROGRAM THROUGH THE CCOS AND CAREOREGON DENTAL, CAREOREGON PROVIDES HEALTH CARE SERVICES TO MORE THAN 255,000 MEDICAID MEMBERS BY CONTRACTING WITH NETWORKS OF COMMUNITY AND PRIVATE MEDICAL PROVIDERS THROUGHOUT THE STATE OF OREGON AND DENTAL PROVIDERS IN THE PORTLAND METRO REGION. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. B. MEDICARE PLAN ON BEHALF OF HEALTH PLAN OF CAREOREGON, PARENT CAREOREGON ADMINISTERS CAREOREGON ADVANTAGE(COA)PLUS, A MEDICARE SPECIAL NEEDS PLAN (SNP). COA PLUS PROVIDES CONTINUITY OF COVERAGE FOR MEMBERS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. THE CONTINUITY BENEFITS BOTH PATIENTS AND PROVIDERS BY ENSURING A COORDINATED AND CONVENIENT MEANS OF RECEIVING AND DELIVERING QUALITY CARE. WE ALSO ADMINISTER CAREOREGON ADVANTAGE STAR, A LOW-COST MEDICARE ADVANTAGE PLAN. OUR MEDICARE PLANS SERVED APPROXIMATELY 13,000 MEMBERS IN 2018. C. CHARITABLE CONTRIBUTIONS WITH CAREOREGON'S GOAL OF CONTINUOUSLY INVESTING IN THE COMMUNITIES WE SERVE, WE CONTRIBUTED ABOUT $3.1 MILLION IN 2018 TO OTHER NONPROFIT CHARITABLE ORGANIZATIONS THAT STRIVE TO IMPROVE HEALTH CARE IN OREGON AND TO IMPROVE HEALTH CARE STATUS OF VULNERABLE AND UNDERSERVED POPULATIONS. D. OTHER PROGRAM SERVICES THE CCOS WE SUPPORT PROVIDE ACCESS FOR APPROXIMATELY 255,000 LOW-INCOME OREGONIANS. OUR WORK INVOLVES COORDINATING QUALITY HEALTH CARE FOR MEMBERS AND CONTRACTING WITH PUBLIC AND PRIVATE PROVIDERS TO PROVIDE HEALTH CARE SERVICES, INCLUDING PHYSICAL, MENTAL AND ORAL HEALTH. WE PROVIDE CUSTOMER SERVICE FUNCTIONS FOR THESE CCOS, ASSIST WITH HEALTH IMPROVEMENT PLANS FOR THE VARIOUS COMMUNITIES AND PROVIDE TECHNICAL SUPPORT FOR INFORMATION SERVICES, HUMAN RESOURCES, COMMUNICATIONS, PROCESS IMPROVEMENT AND OTHER FUNCTIONS. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. CCOS ARE RESPONSIBLE FOR: . INTEGRATING PHYSICAL, MENTAL, DENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT TO ENSURE BETTER CARE FOR THE WHOLE PERSON. . MAINTAINING A COMMUNITY CARE ADVISORY COUNCIL, MADE UP OF AT LEAST 51 PERCENT CONSUMERS, TO ADVISE THE STAFF AND BOARD OF DIRECTORS. . PROVIDING PATIENT-CENTERED PRIMARY CARE HOME (PCPCH) CLINICS. . IMPLEMENTING CONSISTENT ALTERNATIVE PAYMENT METHODOLOGIES THAT ALIGN PAYMENT WITH HEALTH OUTCOMES. . WORKING WITH THEIR COMMUNITIES TO IMPLEMENT COMMUNITY HEALTH ASSESSMENTS AND ADOPTING ANNUAL COMMUNITY HEALTH IMPROVEMENT PLANS. . ENCOURAGING MEANINGFUL USE OF ELECTRONIC HEALTH RECORDS AND HEALTH INFORMATION EXCHANGE. . ENSURING COMMUNICATIONS, OUTREACH, MEMBER ENGAGEMENT AND SERVICES ARE TAILORED TO CULTURAL, HEALTH LITERACY AND LINGUISTIC NEEDS. . DEVELOPING AND IMPLEMENTING A QUALITY IMPROVEMENT PLAN FOCUSED ON ELIMINATING RACIAL, ETHNIC AND LINGUISTIC DISPARITIES IN ACCESS, QUALITY OF CARE, EXPERIENCE OF CARE AND OUTCOMES. CCOS MUST REPORT ON A VARIETY OF PERFORMANCE METRICS EACH YEAR. CCOS MAY EARN BONUS DOLLARS FOR MEETING OR EXCEEDING BENCHMARKS FOR SOME IDENTIFIED METRICS. CAREOREGON'S PARTNER CCOS HAVE CONSISTENTLY BEEN AMONG THE TOP PERFORMING CCOS FOR QUALITY POOL METRICS, WHICH INCLUDE SCREENINGS, HEALTH OUTCOMES AND PAY FOR PERFORMANCE. IN 2018, WE CONTINUED TO PROVIDE COMMUNITY OUTREACH, SUPPORT AND CARE COORDINATION SERVICES TO HIGH-RISK MEMBERS IN MULTNOMAH, WASHINGTON AND CLACKAMAS COUNTIES THROUGH CAREOREGON; IN JACKSON COUNTY THROUGH JACKSON CARE CONNECT; IN COLUMBIA, TILLAMOOK AND CLATSOP COUNTIES THROUGH COLUMBIA PACIFIC CCO. WE ENCOURAGE CLINICS TO PROVIDE THE BEST PRIMARY CARE POSSIBLE THROUGH OUR VARIOUS IMPROVEMENT AND INCENTIVE-PAYMENT PROGRAMS. THE GOAL OF THESE PROGRAMS IS TO BUILD SYSTEMS AND PROCESSES FOR PROACTIVE PANEL MANAGEMENT; TEAM-BASED CARE; CASE MANAGEMENT; PATIENT EMPOWERMENT FOR SELF-MANAGEMENT; INTEGRATION OF PHYSICAL, MENTAL AND ORAL HEALTH CARE; IMMUNIZATION AND DISEASE-SPECIFIC PATIENT REGISTRIES; AND SAME-DAY AND EXTENDED-HOUR MEMBER ACCESS TO THE CARE TEAM. ALL THESE IMPROVEMENTS HAVE THE GOAL OF COST-EFFECTIVE, CONTINUOUS AND COORDINATED CARE. OUR PERSONALIZED HEALTH PROGRAMS FOCUS RESOURCES ON INDIVIDUAL NEEDS AND WELL-BEING. WE SUPPORT MEMBERS WHO ARE AT HIGH RISK AND/OR HAVE COMPLEX HEALTH CONDITIONS BY PROVIDING COORDINATED CARE THAT TAKES INTO CONSIDERATION PAST TRAUMAS. WE FOCUS ON EACH PERSON'S PSYCHOSOCIAL AND CARE MANAGEMENT NEEDS AND HELP MEMBERS TRANSITION FROM HOSPITAL TO HOME. WE PROVIDE HOME-BASED CARE SERVICES AND MEDICATION MANAGEMENT, AND DEVELOP SPECIALTY PRIMARY CARE TEAMS TO ADDRESS NEEDS. . HEALTH RESILIENCE - OUR TEAM OF SOCIAL WORKERS IS EXPERIENCED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDER. WE DEVELOP PARTNERSHIPS BASED ON MUTUAL TRUST WITH MEMBERS WHO FACE THE GREATEST HEALTH CHALLENGES. THEY ADDRESS THEIR LIVING CONDITIONS AS WELL AS HEALTH CONDITIONS TO HELP THEM TRANSITION TO OVERALL WELL-BEING. . TRANSITIONS IN CARE - FOCUS ON THE HOSPITALIZED DUAL-ELIGIBLE POPULATION, WORKING WITH THEM BEFORE THEY ARE DISCHARGED TO REDUCE THE RISK OF READMISSION. . CARE COORDINATION - COORDINATION OF MULTI-DISCIPLINARY CARE FOR PATIENTS WITH COMPLEX MEDICAL ISSUES. . PALLIATIVE CARE - SUPPORT FOR TERMINALLY ILL PATIENTS, REDUCING HOSPITAL AND EMERGENCY DEPARTMENT UTILIZATION RATES. . ADVERSE CHILDHOOD EXPERIENCES (ACES) TRAINING AND SERVICE - BY PARTNERING WITH OUR HEALTH PLANS, WE FOCUS ON TRAINING STAFF, PROVIDERS, EDUCATORS AND OTHER COMMUNITY MEMBERS ABOUT THE IMPORTANCE OF RECOGNIZING ACES. PROVIDERS PRACTICING TRAUMA-INFORMED CARE TAKE INTO ACCOUNT THE PATIENT'S HISTORY, AND ADJUST THEIR TREATMENT TO SUPPORT THE INDIVIDUAL'S COPING CAPACITY. PART IV, LINE 12/12A CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2018, AN AUDIT WAS PERFORMED ON THE CONSOLIDATED ENTITY WHICH INCLUDES CAREOREGON, INC., HEALTH PLAN OF CAREOREGON, INC., CARE ACCESS LLC, COLUMBIA PACIFIC CCO, LLC, JACKSON COUNTY CCO, LLC, HOUSECALL PROVIDERS SERVICES, LLC, AND HOUSECALL PROVIDERS, PC. PART VI, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS AMIT SHAH, MD IS A CHIEF MEDICAL OFFICER OF CAREOREGON AND SERVES AS A MEMBER OF THE BOARD OF DIRECTORS OF HOUSECALL PROVIDERS, PC. SHAH HOLDS 51% OWNERSHIP AND CAREOREGON HOLDS 49% OF HOUSECALL PROVIDERS, PC WHICH IS A FULLY-CONSOLIDATED SUBSIDIARY OF CAREOREGON FOR FINANCIAL REPORTING PURPOSES. PART VI, LINE 11A FORM 990 TO GOVERNING BODY CAREOREGON'S FORM 990 GOES THROUGH MULTIPLE LAYERS OF REVIEWS BEFORE IT IS REVIEWED BY THE CFO, FINANCE COMMITTEE AND THE BOARD OF DIRECTORS BEFORE IT IS FILED. THE FORM 990 IS REVIEWED AND DISCUSSED AT THE FINANCE COMMITTEE MEETING PRIOR TO FILING. ALL REVIEWERS ARE GIVEN TIME TO RESPOND WITH ANY REVISIONS. AFTER INCORPORATION OF ALL REVISIONS, THE FORM 990 IS REDISTRIBUTED TO THE REVIEWERS FOR A FINAL REVIEW PRIOR TO FILING. PART VI, LINE 12C ENFORCEMENT OF CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST POLICY OF CAREOREGON IS DISTRIBUTED TO THE BOARD MEMBERS ANNUALLY. IT APPLIES TO DIRECTORS, OFFICERS AND KEY EMPLOYEES (ON THE BASIS OF TESTS SET FORTH IN IRS FORM 990), AND ANY OTHER INDIVIDUAL IN A POSITION TO EXERCISE SIGNIFICANT INFLUENCE OVER A DECISION HAVING MATERIAL ECONOMIC IMPACT FOR CAREOREGON (COLLECTIVELY COVERED PERSONS). THE CONFLICT OF INTEREST POLICY IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD. AN ANNUAL CONFLICT OF INTEREST DECLARATION AND INDEPENDENCE QUESTIONNAIRE IS DISTRIBUTED TO ALL COVERED PERSONS. THROUGH THE DISTRIBUTED DOCUMENT, EACH COVERED PERSON SIGNS AND ACKNOWLEDGES THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY AND REPORTS FAMILY AND BUSINESS RELATIONSHIPS THAT ARE USED TO DETERMINE THE INDEPENDENCE OF A DIRECTOR PURSUANT TO THE DEFINITION AND TESTS SET FORTH IN IRS FORM 990. THE GOVERNANCE COMMITTEE REVIEWS THE RESPONSES TO THE ANNUAL QUESTIONNAIRES AND MAKES RECOMMENDATIONS TO THE FULL BOARD ON ANY RESOLUTIONS OR ACTIONS REQUIRED TO MITIGATE ANY CONFLICTS OF INTEREST. FOR 2018, THERE WERE NO CONFLICTS OF INTEREST REQUIRING RESOLUTION OR ACTIONS. AT THE BEGINNING OF EACH MEETING OF THE BOARD OF DIRECTORS, THE CHAIR ASKS ALL MEMBERS PRESENT TO DECLARE ANY CONFLICTS OF INTEREST SO THE BOARD IS UPDATED ON ANY NEW CONFLICTS THAT MAY HAVE ARISEN SINCE THE LAST ANNUAL QUESTIONNAIRE. ALL SIGNED CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENTS AND INDEPENDENCE QUESTIONNAIRES ARE RETAINED AT CAREOREGON'S OFFICE. IF FOR A SPECIFIC MATTER REQUIRING BOARD ACTION, A CONFLICT OF INTEREST EXISTS, AS DETERMINED BY THE BOARD, AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE MEETING, DISCLOSING THE EXISTENCE OF HIS OR HER INTEREST AND SHALL DISCLOSE ALL MATERIAL FACTS. FOLLOWING THE PERSON'S DISCLOSURES AND AFTER ANY DISCUSSION WITH THE BOARD, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD INDEPENDENTLY DISCUSSES THE MATTER BEFORE IT VOTES ON THE PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. IF THERE IS REASONABLE QUESTION ABOUT THE APPROPRIATENESS OF THE PROPOSED TRANSACTION OR ARRANGEMENT, THE CHAIR SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTIONS OR ARRANGEMENTS. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL EVALUATE THE RESULTING ALTERNATIVES PRESENTED BY THE APPOINTED PERSON OR COMMITTEE. IF AN APPROPRIATE CONFLICT-FREE ALTERNATIVE IS NOT REASONABLY ATTAINABLE, THE BOARD SHALL DETERMINE BY MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN CAREOREGON'S BEST INTEREST, FOR CAREOREGON'S OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CAREOREGON, AND WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. THE BOARD SHALL THEN VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN CAREOREGON'S BEST INTEREST, FOR CAREOREGON'S OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CAREOREGON, AND WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. THE BOARD SHALL THEN VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. PART VI, LINE 15A AND 15B PROCESS OF DETERMINING COMPENSATION MARKET DATA ON THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVE POSITIONS (CEO, COO, CFO, CLO, AND CMO) IS PROVIDED ANNUALLY BY AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT USING COMPARABLE ORGANIZATIONS BY INDUSTRY, PROFIT/NON-PROFIT STATUS AND REVENUE SIZE. THE COMPENSATION COMMITTEE, CONSISTING OF A MAJORITY OF INDEPENDENT BOARD MEMBERS, REVIEWS MARKET DATA, EVALUATES CEO PERFORMANCE AND REVIEWS CEO RECOMMENDATIONS FOR COMPENSATION FOR OTHER EXECUTIVE OFFICERS. THE COMMITTEE PRESENTS ITS RECOMMENDATIONS FOR CEO TO THE BOARD. DECISIONS ARE MADE IN A BOARD MEETING. THE BOARD REVIEWS THE RECOMMENDATION FOR THE COMPENSATION OF ALL OTHER EMPLOYEES AS PART OF THE BUDGET APPROVAL PROCESS. THE PROCESS OF DETERMINING THE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY OFFICERS INCLUDES A REVIEW OF AN INDEPENDENT CONSULTANT'S REPORT OF COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS AND IS GUIDED BY WRITTEN COMPENSATION PRACTICES. WITH THE CEO AND ALL OTHER OFFICERS ABSENT FROM THE MEETINGS, THE BOARD APPROVES THE SALARY OF THE CEO. THIS PROCESS WAS LAST UNDERTAKEN ON MARCH 8, 2019 FOR THE CEO, AND THE CEO'S RECOMMENDATIONS FOR OTHER OFFICERS. THERE IS CONTEMPORANEOUS DOCUMENTATION OF THIS PROCESS AND THE RESULTS. PART VI, LINE 18 AND 19 PUBLIC INSPECTION THE TAX RETURN INFORMATION IS AVAILABLE UPON REQUEST. WHILE NO REQUIREMENT TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXISTS, CAREOREGON WILL CONSIDER ALL REQUESTS FOR THESE DOCUMENTS ON A CASE-BY-CASE BASIS. PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES K-1 PARTNERSHIP INCOME, NOT INCLUDED IN BOOKS $ (1,035) TRANSFER FROM CAREOREGON 7,500,000 ------------- Total $ 7,498,965 IN 2018, CAREOREGON TRANSFERRED $5,000,000 TO HEALTH PLAN OF CAREOREGON, ITS WHOLLY-OWNED SUBSIDIARY, TO MEET RISK BASED CAPITAL (RBC) REQUIREMENTS. CAREOREGON ALSO TRANSFERRED $2,500,000 TO HOUSECALL PROVIDERS, PC FOR ITS OPERATIONS. 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