2018-11-05T16:43:18-06:00 2017-12-31 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2017-01-01 930933975 CAREOREGON INC % TERESA KENNEDY LEARN CFO CARE 5034164100 315 SW 5TH AVE PORTLAND OR 97204 TERESA K LEARN CFO 5034161415 2018-11-01 true Sue Robison P00560072 2069134000 167.68.102.5 91023620183095000002 2018-11-05 P F1CC860431B62FC38C807B6E7C61BB7101565A90 B2085296070B2518CC0515A081EE2B047671701D 2017 2019-02-21 02:37:17Z Eric Hunter 315 SW 5TH AVE PORTLAND OR 97204 987569869 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 13 927 141 16408580 -128736 339602 474102 869906422 824022338 8145525 24436340 8092739 12275705 886484288 861208485 6948952 4057806 0 0 67227382 76035386 0 0 0 821753295 821699771 895929629 901792963 -9445341 -40584478 417953032 417596891 129412303 190643196 288540729 226953695 X SEE SCHEDULE O true false 818795871 792362320 OHP PROGRAM - SEE SCHEDULE O FOR DESCRIPTION. 17892395 18924016 MEDICARE PLAN - SEE SCHEDULE O FOR DESCRIPTION. 4057806 4057806 CHARITABLE CONTRIBUTIONS- SEE SCHEDULE O FOR DESCRIPTION. 12107895 12734684 852853967 true true false true false false false false false false true true false false true true false true false false true 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 2244 0 true 927 true true true false false false false false false false false false X 14 13 true 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 SUITE 900 Portland OR 97204 Vickie S Gates Board Vice Chair 2.75 1.25 X X 0 0 0 Glenn S Rodriquez Board Chairman 2.75 1.25 X X 0 0 0 Susan M Hennessy Board of Director 2.75 1.25 X 0 0 0 Beth A deHamel Board of Director 2.75 1.25 X 0 0 0 Joanne Fuller Board of Director 2.75 1.25 X 0 0 0 DAMIEN R HALL Board of Director 2.75 1.25 X 0 0 0 BRENDA I JOHNSON Board of Director 2.75 1.25 X 0 0 0 Nathalie Johnson Board of Director 2.75 1.25 X 0 0 0 Hyosuk Rhee Board of Director 2.75 1.25 X 0 0 0 Robert C Stewart Board of Director 2.75 1.25 X 0 0 0 Erik W Thorsen Board of Director 2.75 1.25 X 0 0 0 Gina F Nikkel Board of Director 2.75 1.25 X 0 0 0 Woodruff J English II Board of Director 2.75 1.25 X 0 0 0 Eric C Hunter CEO, President & Board of Dire 31.04 8.96 X X 440879 0 25078 Katherine A Ellis COO, Board Secretary 31.04 8.96 X 325328 0 33242 Teresa K Learn CFO, Board Treasurer 31.04 8.96 X 351827 0 33497 Amit R Shah CHIEF MEDICAL OFFICER 31.04 8.96 X 346588 0 20654 Gregory P Morgan Chief Network Officer 31.04 8.96 X 147970 0 24668 Scott W Clement INTEGRATION-BDO 31.04 8.96 X 61409 0 19159 Nathan Corley Information Services Director 30.53 9.47 X 181361 0 22754 Douglas R Luther Sr Med Director - operations 32.45 7.55 X 293756 0 24806 William J Kennedy SR MED DIRECTOR - CLINICAL SVC 8.08 31.92 X 277801 0 44624 Carl D Stevens Medical Director 32.45 7.55 X 250884 0 38639 Safina Koreishi Medical Director 36.08 3.92 X 236470 0 23571 Rebecca Ramsay HOUSECALL PROVIDERS EXE DIRECT 13.43 26.57 X 212698 0 41274 3126971 0 351966 120 false true false CDW Direct LLC PO Box 75723 CHICAGO IL 60675 Computers/Maint/Fees 543348 HealthTrio LLC 400 S Colorado Blvd Suite 540 DENVER CO 80246 Administrative 526549 AterWynne LLP 1331 NW Lovejoy Ste 900 PORTLAND OR 97209 Legal services 366978 Red-Card Systems LLC 744 Office Parkway SAINT LOUIS MO 63141 Claims processing 335199 Kaufman Hall and Associates Inc 8610 Solutions Center CHICAGO IL 60677 Consulting 276240 12 369478 104624 474102 PREMIUM REVENUE 524114 792362320 792362320 MANAGEMENT FEE 541611 27722699 20336122 7386577 TRAINING REVENUE 611430 258914 228509 30405 PATIENT REVENUE 621610 2624562 2624562 ALL OTHER PROGRAM SERVICE REVENUE 900099 1053843 862579 191264 824022338 6928018 6928018 0 0 404783 256927 147856 0 147856 -1485 149341 143612779 125804313 300144 17808466 -300144 17508322 17508322 0 0 0 0 0 0 0 0 0 EMPLOYEE LEASE REVENUE 541611 11479692 2677873 8801819 CONTRIBUTIONS RECEIVED 900099 648157 648157 12127849 861208485 819740122 16408580 24585681 4057806 4057806 0 0 0 2034413 2034413 0 58086831 36566495 21520336 3709274 2297907 1411367 7493879 5282755 2211124 4710989 2876260 1834729 0 486678 486678 271696 271696 266623 266623 0 712462 1434 711028 7514622 4135243 3379379 956861 875492 81369 1644988 1164807 480181 5441249 38849 5402400 0 1732308 24015 1708293 663233 421515 241718 0 473166 182102 291064 -12792 -12792 0 4674904 4674904 255673 5575 250098 PHYSICAL HEALTHCARE EXPENSE 666117532 666117532 DENTAL HEALTHCARE EXPENSE 27672610 27672610 MENTAL HEALTHCARE EXPENSE 37125171 37125171 PASS THROUGH REVENUE EXPENSE 32252341 32252341 33450446 31756058 1694388 901792963 852853967 48938996 0 597 52000 49772899 46894590 0 159131 33354400 36539342 0 0 0 0 1940629 1196450 0 343 4061845 3922929 48419359 27222858 25016941 21196501 211291619 229806481 90234676 73317654 0 0 0 0 2279426 4511470 417953032 417596891 16247463 23047249 0 0 237458 368153 0 0 0 0 0 0 0 0 0 0 112927382 167227794 129412303 190643196 X 288188722 226853465 352007 100230 0 0 288540729 226953695 417953032 417596891 X -40584478 -3982755 -18618 -17001183 X false true X true false X 1526389 1676151 1144558 339602 474102 5160802 558281700 832133142 918922129 862474890 816414092 3988225953 0 0 0 559808089 833809293 920066687 862814492 816888194 3993386755 0 0 0 3993386755 4037837 4841109 6384386 6830965 7332802 29427099 0 4037837 4841109 6384386 6830965 7332802 29427099 0 0 563845926 838650402 926451073 869645457 824220996 4022813854 0.99269 0.99305 0.00732 0.00695 X 18676 247947 266623 901526340 901792963 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 190547 115147 92888 266623 665205 250000 250000 250000 250000 1000000 1500000 18676 18676 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 or contribute to political candidate campaigns or political parties. false false 2704520 2704520 21507496 9140582 12366914 458059 393998 64061 8111896 6661199 1450697 15637388 11027079 4610309 21196501 POOLED FUNDS 73317654 F 73317654 0 CLAIMS PAYABLE 73917033 ABA RISK CORRIDOR PAYABLE 909906 PAY FOR PERFORMANCE INCENTIVE 42179452 PREMIUM DEFICIENCY RESERVE 39354000 HOSPITAL INCENTIVE PAYABLE 652514 PREMIUM RECOUPMENT PAYABLE 3942646 INTERCOMPANY LIABILITIES 409066 HOSPITAL REIMBURSEMENT PAYABLE 53511 HEPC RISK CORRIDOR PAYABLE 5809666 167227794 X Part X, Line 2 The internal revenue services (IRS) has recognized CareOregon as exempt from federal income taxs under provisions of section 501 (c) (3) of the internal revenue code. The whollly-owned subidiary, Health Plan of CareOregon, is a Medicare Advantage Plan reported on separate Form 990. On July 14, 2017, the IRS has approved Health Plan of CareOregon's application for exemption from federal income tax, effective December 31, 2016. The wholly-owned subsidiaries, Columbia Pacific CCO, LLC; Jackson Care Connect CCO, LLC; Care Access, 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. Management regularly assesses the likelihood that deferred tax assets will be recovered from future taxable income, and records a valuation allowance, if necessary, to reduce deferred tax assets to the amounts believed to be realizable. 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 exess 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. Housecall Providers, PC will file a separate Form 990. Europe (Including Iceland and Greenland) 1 Program Services CONSULTING SERVICES 20000 East Asia and the Pacific Program Services Goods purchased 3837 North America Program Services Goods purchased & Serv 4153 1 1 27990 27990 false false false false false false Part I Line 3 column F Explanation: Accrual true African Youth and Community Organization (AYCO) 1390 SE 122nd Ave Suite UE Portland OR 97280 272581852 501(c)(3) 20000 Healthcare/disabilities Cultural Liaison Ant Farm 39140 Proctor Blvd Sandy OR 97055 931326167 501(c)(3) 10000 Learning Garden pairs youth & seniors with gardening Black Parent Initiative PO Box 12350 Portland OR 97212 205686374 501(c)(3) 59000 2018 Sacred Roots Doula Expansion Project Bridge Meadows 8502 N Wayland Ave Portland OR 97203 202028975 501(c)(3) 45000 Building Resilience & wellness through intergenerational place Permanence & purpose Asian Pacific American Network of Oregon PO Box 6552 Portland OR 97208 800252850 501(c)(3) 31500 Support for roots to rise capital campaign Central City Concern 232 NW Sixth Avenue Portland OR 97209 930728816 501(c)(3) 1343334 Eastside Integrated Housing and Services Campus Children's Nursing Specialties Inc 9900 SW Greenburg Rd Ste 290 Portland OR 97223 593796997 501(c)(3) 11833 Delegation Nurse Program Community Partners for Affordable Housing Inc PO Box 23206 Tigard OR 97281 931155559 501(C)(3) 7850 Thriving at home plan of action DePaul Treatment Centers PO Box 3007 PORTLAND OR 97208 930706892 501(c)(3) 51500 Youth Outreach & In-School Addictions Counselor Dental 3 7420 SW Hunziker Suite F Portland OR 97223 472609004 501(c)(3) 93221 Contribution for providing dental preventive services for uninsured children Janus Youth Programs Inc 707 NE Couch St Portland OR 97232 237345990 501(c)(3) 16000 Healthy Kids and Families - Village Market Families - Village Market Kairos Northwest PO Box 12190 Portland OR 97212 460987167 501(C)(3) 63500 Culturally Responsive Trauma Informed Care Kukatonon PO Box 80861 Portland OR 97280 931195546 501(c)(3) 10500 Building Kukatonons Organizational Capacity to Facilitate Program growth that will get kids active La Clinica Del Velle Family Health Care Center Inc 3617 S Pacific Highway Medford OR 97501 943096772 501(C)(3) 793640 Loan Forgiveness - Primary Care Investment Fund Program Lines for Life 5100 SW Macadam Ave Ste 400 Portland OR 97239 930725294 501(c)(3) 11500 Annual OPG Conference MacDonald Center 121 NW 6th Ave Portland OR 97209 931060938 501(c)(3) 45000 Building Community & Connection for Low income individuals Mike Program 9155 SW Barnes Rd Ste 219 Portland OR 97225 450520604 501(c)(3) 11500 Mentored Health Education for high priority youth: Understanding our stakeholders Multnomah County Health Department 421 SW Oak Street 201 Portland OR 97204 936002309 County 114900 MCMH Target Milestones Achieved Native American Youth and Family Center 5135 NE Columbia Blvd Portland OR 97218 931141536 501(c)(3) 25000 Potlatch to give leval sponsor for 14th Annual Gala and Auction North by Northeast Community Health Center 714 NE Alberta St Portland OR 97211 721618287 501(c)(3) 10000 Sponsorship for 10th Anniversary Event Northwest Regional Education Service District 5825 NE Ray Circle Hillsboro OR 97124 936000311 State 68350 Columbia County TIC/ACEs Learning Collaborative Phase 2 Northwest Housing Alternatives Inc 2316 SE Willard St Milwaukie OR 97222 930814473 501(c)(3) 25000 Annie Ross House Emergency Shelter for Homeless families Northwest Pilot Project Inc 1430 SW Broadway 200 Portland OR 97201 930635871 501(c)(3) 36500 Housing case management for extremely low income seniors of color Portland Community Reinvestment Initiatives Inc 6429 NE Martin Luther King Jr Blvd Portland OR 97211 931059146 501(c)(3) 50000 PCRI's homeownership retention program Public Health Foundation of Columbia County PO Box 995 St Helens OR 97051 810622430 501(c)(3) 87790 PCIF Loan Forgiveness - Primary Care Investment fund Program Reading Results 3115 NE Sandy Blvd Ste 229 Portland OR 97232 201760894 501(c)(3) 10000 Ensure More Students are on a path to success Refugee Disability Benefits Oregon 1220 SW Morrison St Ste 932 Portland OR 97205 811735941 501(c)(3) 20000 Health Equity for Refugees and Immigrants Restoration House Inc PO Box 641 Seaside OR 97138 931271134 501(c)(3) 40000 Investment development grant to keep restoration house functioning functioning Rogue Retreat 1410 W 8th St Medford OR 97501 931261999 501(C)(3) 7000 WaterBottle FilingStation Rose Haven CIC PO Box 10405 Portland OR 97296 205922682 501(c)(3) 20000 Capacity Investment Shower Program Expansion Southern Oregon Education Service Dist 101 North Grape St Medford OR 97501 936008718 State 10000 SORS ACE Training Southern Oregon University 1250 Siskiyou Blvd Ashland OR 97520 472963287 State 24000 SOU/RCC ACES Training Program The Lund Report PO Box 82841 Portland OR 97282 263019179 501(c)(3) 25000 Sponsorship for 2018 Oregon Health Forum Store to Door 7730 SW 31st St Portland OR 97208 943105555 501(c)(3) 10000 Store to door in reach project Teaching Preschool Partners 2608 SW Buena Vista Place Portland OR 97201 471085469 501(c)(3) 20000 Build out habits of mind assessments tool to support teachers The Shadow Project 2154 NE Broadway Ste 130 Portland OR 97232 651166066 501(c)(3) 16000 Advancing Equity for Children with Learning Challenges The Village Coalition 4815 NE 7th Ave Portland OR 97211 814407954 501(c)(3) 60000 Village community restorative justice training program Trillium Family Services Inc 3415 SE Powell Portland OR 97202 930386966 501(c)(3) 40000 Keep Oregon Well Tucker-Maxon School 2860 SE Holgate Portland OR 97202 930391592 501(c)(3) 11000 Diagnosing Hearing loss for oregon children Urban Gleaners PO Box 6344 Portland OR 97228 204641665 501(c)(3) 20000 Support for Reducing Food Insecurity Virginia Garcia PO Box 568 Cornelius OR 97113 930717997 501(c)(3) 498500 PCIF Loan Forgiveness - Primary Care Investment Fund Wallace Medical Concern 124 NE 181st Ave Ste 103 Portland OR 97230 930853709 501(c)(3) 10000 Connect, Enroll, Engage! Wilson Strategic Communications 3500 188th St SW Ste 590 Lynnwood OR 98037 201502691 CORP 7500 Sponsorship of 2017 Oregon State Reform Health Policy Conference 42 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 Katherine A Ellis COO, Board Secretary 267190 26350 31788 18204 15038 358570 Teresa K Learn CFO, Board Treasurer 251995 25556 74276 18361 15136 385324 Amit R Shah CHIEF MEDICAL OFFICER 315946 30042 600 18800 1854 367242 Douglas R Luther Sr Med Director - operations 283187 9568 1001 18092 6714 318562 William J Kennedy SR MED DIRECTOR - CLINICAL SVC 267618 9163 1020 18630 25994 322425 Eric C Hunter CEO, President & Board of Dire 405564 35000 315 18518 6560 465957 Carl D Stevens Medical Director 239142 11742 16770 21869 289523 Safina Koreishi Medical Director 225555 10915 16008 7563 260041 Gregory P Morgan Chief Network Officer 147970 7687 16981 172638 Rebecca Ramsay HOUSECALL PROVIDERS EXE DIRECT 205081 6702 915 15090 26184 253972 Nathan Corley Information Services Director 181361 11357 11397 204115 PART I, LINE 1A CareOregon reimbursed health club dues for Eric Hunter, CEO, Katherine Ellis, COO, William Kennedy, Sr. Medical Director, Douglas Luther, Senior Medical Director, Carl Stevens, Medical Director, Rebecca Ramsay, Housecall Providers Director, and Safina Koreishi, Medical Director in the amount of $315, $210, $420, $401, $105, $315 and $315 respectively. This reimbursement was included as taxable compensation to these parties. SUPPLEMENTAL INFORMATION TO 2017 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 AND EDUCATIONAL 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 185,000 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 CARE CONNECT CCO, LLC, IN JACKSON COUNTY; AND COLUMBIA PACIFIC CCO, LLC, IN COLUMBIA, TILLAMOOK AND CLATSOP COUNTIES. . HEALTH SHARE OF OREGON 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. . 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 CCO AND OREGON HEALTH PLAN'S OPEN CARD PROGRAM IN THE PORTLAND METRO REGION. IN 2017, IT ALSO SERVED FAMILYCARE MEMBERS; FAMILYCARE CLOSED FEBRUARY 2018. . 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. PART III, LINE 2 NEW PROGRAM SERVICES IN 2017, HOUSECALL PROVIDERS SERVICES, LLC AND HOUSECALL PROVIDERS, PC JOINED THE CAREOREGON FAMILY. HOUSECALL PROVIDERS SERVICES, LLC PROVIDES HOME-BASED CARE AND HOSPICE SERVICES. HOUSECALL PROVIDERS, PC OFFERS MEDICAL CARE, INTEGRATING PRIMARY AND PALLIATIVE SERVICES FOR HOMEBOUND MEMBERS IN THE PORTLAND METRO REGION. ALSO IN 2017, THE OREGON HEALTH AUTHORITY (OHA)CONTRACTED WITH CAREOREGON TO PROVIDE CARE COORDINATION TO AMERICAN INDIANS AND ALASKA NATIVES ON THE OREGON HEALTH PLAN. THE ORIGINAL REQUEST FOR THIS NEW 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 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 185,000 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 2017. C. CHARITABLE CONTRIBUTIONS WITH CAREOREGON'S GOAL OF CONTINUOUSLY INVESTING IN THE COMMUNITIES WE SERVE, WE CONTRIBUTED ABOUT $4.0 MILLION IN 2017 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 185,000 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. ALL CAREOREGON-AFFILIATED CCOS EARNED 100 PERCENT OR MORE OF THE OREGON HEALTH AUTHORITY PAYOUT FOR 2017. IN 2017, 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 ALSO PROVIDE EXTENSIVE SUPPORT TO YAMHILL COUNTY BY PARTNERING WITH YAMHILL COMMUNITY CARE ORGANIZATION, A SEPARATE ENTITY. 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 - A TEAM OF SOCIAL WORKERS EXPERIENCED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDER DEVELOPS 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, 2017, AN AUDIT WAS PERFORMED ON THE CONSOLIDATED ENTITY WHICH INCLUDES CAREOREGON, HEALTH PLAN OF CAREOREGON,CARE ACCESS, COLUMBIA PACIFIC CCO, JACKSON CARE CONNECT, HOUSECALL PROVIDERS SERVICES, AND HOUSECALL PROVIDERS. PART VI, LINE 2 FAMILY AND BUSINESS RELATIONSHIP AMIT SHAH, MD IS A CHIEF MEDICAL OFFICER OF CAREOREGON AND SERVES AS A MEMBER OF 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 IS REVIEWED BY THE CFO, FINANCE COMMITTEE AND APPROVED BY 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 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 PERIODICALLY 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 2017, 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. PART VI, LINE 15A AND 15B PROCESS OF DETERMINING COMPENSATION MARKET DATA ON THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVE POSITIONS (CEO, COO, CFO, 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 30, 2017 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 $ 1,183 Transfer from CareOregon $ 17,000,000 ------------- Total $ 17,001,183 IN 2017, CAREOREGON TRANSFERRED $15,000,000 TO HEALTH PLAN OF CAREOREGON, ITS WHOLLY-OWNED SUBSIDIARY, TO MEET RISK BASED CAPITAL (RBC)REQUIREMENTS. CAREOREGON ALSO TRANSFERRED $2,000,000 TO HOUSECALL PROVIDERS, PC FOR ITS OPERATIONS. Columbia Pacific CCO LLC 315 SW Fifth Avenue Portland OR 97204 455532847 MEDICAID OR 151921493 28406536 CareOregon Jackson County CCO LLC 315 SW Fifth Avenue Portland OR 97204 455499608 MEDICAID OR 146009167 42738219 CareOregon Care Access LLC 315 SW Fifth Avenue Portland OR 97204 270630449 Medical Bldg OR 98364 3865860 CareOregon Housecall Providers Services LLC 315 SW Fifth Avenue Portland OR 97204 821474020 HOSPICE SVC OR 3389109 3194957 CareOregon Health Plan of CareOregon Inc 315 SW Fifth Avenue Portland OR 97204 463264330 Medicare OR 501(c)(3) 10 Careoregon true Housecall Providers PC 315 SW Fifth Avenue Portland OR 97204 821663503 Medical Care OR 501(C)(3) 10 Careoregon true false false false false false false false false false false true true true true false true true false Health Plan of CareOregon l, n 18924016 Actual Cost Health Plan of CareOregon q 1358956 Reimbursed Health Plan of CareOregon r 15000000 transferred Housecall Providers PC l,n,o 4089979 Actual Cost Housecall Providers PC m 113200 clinical serv Housecall Providers PC q 95587 Reimbursed Housecall Providers PC r 2000000 transferred