2012-10-22T16:31:53-05:00 2011-12-31 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2011-01-01 930933975 CAREOREGON INC % TERESA K LEARN CARE 5034161415 315 SW 5TH AVE 9TH FLOOR PORTLAND OR 97204 Teresa Learn 2012-10-16 true 2069134000 2011 2016-02-24 21:20:13Z David E Ford 315 SW 5th Ave 9th Floor Portland OR 97204 616197008 false X WWW.CAREOREGON.ORG X 1994 OR CAREOREGON IS A COMMUNITY BENEFIT ORGANIZATION WHOSE MISSION IS TO ASSURE VULNERABLE POPULATIONS ACCESS TO HIGH QUALITY HEALTHCARE FROM A STABLE NETWORK BY A WELL-MANAGED, FINANCIALLY SOUND ORGANIZATION. 14 11 375 27 6225 4166 0 50000 459742418 568153396 9603940 4358571 -2791 27427 469343567 572589394 667519 9034239 0 0 23465295 25644945 0 0 0 438243280 511551730 462376094 546230914 6967473 26358480 199949462 208688201 79704827 60367871 120244635 148320330 X CAREOREGON IS A COMMUNITY BENEFIT ORGANIZATION WHOSE MISSION IS TO ASSURE VULNERABLE POPULATIONS ACCESS TO HIGH QUALITY HEALTHCARE FROM A STABLE NETWORK BY A WELL-MANAGED, FINANCIALLY SOUND ORGANIZATION. false false 511286638 557310948 See Schedule O for description. 8636901 8852151 See Schedule O for description. 9034239 9034239 See Schedule O for description. 4210588 1990297 533168366 true true false true false false false true false true true false true true true false true false false false false false false false false false true false true false false false false false false true true false false false false true true true true false false true 1974 0 true 375 true true true false false false false false false false false false X 14 11 true false true false false false false true true false false true true true true true true true true false OR X TERESA K LEARN 5034161415 315 SW 5TH AVE SUITE 900 PORTLAND OR 97204 X Colleen A Cain 4.0 X 0 0 0 Susan M Clack MD 4.0 X 0 0 Christopher J Krenk 4.0 X X 0 0 Lynnwood R Lundquist 4.0 X 0 0 J Bart McMullan JR MD 4.0 X 0 0 Gilles M Munoz 4.0 X X 0 0 Vickie S Gates 4.0 X 0 0 Nathalie Johnson 4.0 X 0 0 Mylia Christensen 4.0 X 0 0 Robert Stewart 4.0 X 0 0 David E Ford 40.0 X X 414067 43123 Beth deHamel 4.0 X 0 0 James A Diegel 4.0 X 0 0 Amit R Shah 4.0 X 0 0 Carolyn J Rankin 40.0 X 316760 32290 Margaret S Rowland 40.0 X 281234 34092 David Labby 40.0 X 257594 31797 Patrick J Curran 40.0 X 146829 23340 Angela I Uba 40.0 X 142599 17322 Teresa K Learn 40.0 X 140776 23512 Martin P Taylor 40.0 X 138826 20977 1838685 0 226453 28 false true false Providence Health System PO Box 3395 PORTLAND OR 97208 Medical Services 68282782 LEGACY HEALTH SYSTEM PO Box 4037 PORTLAND OR 97208 Medical Services 66655902 OREGON HEALTH SCIENCES UNIVERSITY PO Box 3595 PORTLAND OR 97208 Medical Services 62785211 Portland Adventist Medical Center 10123 SE Market St PORTLAND OR 97216 Medical Services 13866594 Asante 100 E Main St Ste C MEDFORD OR 97501 Medical Services 10667149 239 50000 50000 PREMIUM REVENUE 524114 557310948 557310948 CLINIC SERVICES REVENUE 524114 1395724 1395724 OTHER PROGRAM SERVICE REVENUE 524114 168661 168661 MANAGEMENT FEES 900099 9278063 9278063 568153396 3648272 3648272 0 0 420852 393425 27427 27427 6225 21202 43924488 43214189 710299 710299 710299 0 0 0 0 572589394 568153396 6225 4379773 9034239 9034239 0 0 0 1121567 760017 361550 0 0 0 18660407 12938953 5721454 0 1681474 1137285 544189 0 2527011 1876179 650832 0 1654486 1177041 477445 0 418046 418046 0 197646 186632 11014 84350 84350 202052 25000 177052 0 379369 208541 170828 3773893 3256630 517263 0 835102 523546 311556 3969894 2033111 1936783 0 848277 494873 353404 236994 100607 136387 0 297805 79495 218310 207 207 0 2634143 2376092 258051 161757 161757 INPATIENT/OUTPATIENT EXPENSE 210161661 210161661 PROFESSIONAL MEDICAL EXPENSE 125936815 125936815 PHARMACY EXPENSE 56812371 56812371 HRA AND GME EXPENSE 64816480 64816480 39784868 39232798 552070 546230914 533168366 13062548 0 0 0 15620519 18228230 0 0 10520595 10461583 0 0 0 0 0 0 15910 0 2034410 1954415 36561293 14918708 22991602 21642585 104087861 110969477 32220072 32144402 0 0 0 0 12458493 13287509 199949462 208688201 2737921 4489562 0 0 16933 0 0 0 2944182 0 0 0 0 0 0 0 74005791 55878309 79704827 60367871 X 120244635 148320330 0 0 0 0 120244635 148320330 199949462 208688201 X 26358480 1717215 X false true true X false X 21765 8591 50000 80356 262645564 339310712 384692255 464742418 568153396 2019544345 262667329 339319303 384692255 464742418 568203396 2019624701 2019624701 4640589 4545589 4104341 3681803 4069125 21041447 4640589 4545589 4104341 3681803 4069125 21041447 8327 9153 8676 5740 31896 267307918 343873219 388805749 468432897 572278261 2040698044 0.98967 0.98757 0.01031 0.01241 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 202052 202052 546028863 546230915 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 133816 336159 223836 202052 895863 250000 250000 250000 250000 1000000 1500000 3809 28751 0 32560 Lobbying Activities Part II-A, Line 1 CareOregon participates in lobbying activities that include testifying at public policy hearings, meeting with legislators to discuss Oregon Health Plan related issues, hosting educational sessions and supporting or opposing ballot measures that impact Oregon Health Plan members. CareOregon does not participate or contribute to political candidate campaigns or political parties. false true 2704520 2704520 17881570 3915215 13966354 0 0 0 7824229 4612545 3211683 8150975 6390948 1760028 21642585 POOLED FUNDS 32144402 F 32144402 INVESTMENT IN SUBSIDIARY 11400000 457(B) PLAN ASSETS 7233 INTERCOMPANY RECEIVABLE 1870390 DEPOSIT RECEIVABLE 9886 13287509 0 CLAIMS PAYABLE 43694836 DMAP RECOUPMENT PAYABLE 1483692 MANAGED CARE TAXES PAYABLE 1440188 457(B) PLAN LIABILITIES 7233 HOSPITAL REIMBURSEMENT PAYABLE 429405 PREMIUM DEFICIENCY RESERVE 7000000 INTERCOMPANY LIABILITY 343987 GRADUATE MEDICAL EDUCATION PAYABLE 1478968 55878309 ASC 740 Footnote Part X, Line 2 The Organization recognizes the tax benefit from uncertain tax positions only if it is more likley 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 measursed based on the benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Organization recognizes interest and penalites 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. Escrow Account Liability Part IV, Line 2 The company held amounts at the beginning of the year in an escrow account to demonstrate a good faith effort to eventually pay amounts owed while resolving a difference of opinion in regards to other amounts due to a healthcare provider. At the end of the current tax year, the difference of opinion has been resolved and there are no longer any amounts held in escrow. true Albertina Kerr Centers 424 NE 22nd Avenue Portland OR 97232 930386780 501(c)(3) 35145 SERVICE FOR DISABLED CHILDREN Cascadia Behavioral Healthcare Inc 847 NE 19th Ave Portland OR 97232 930770054 501(c)(3) 150000 MENTAL HEALTH JOINT EFFORT ON MEDICARE Central City Concern 232 NW Sixth Ave Portland OR 97209 930728816 501(c)(3) 255000 SUPPORT OLD TOWN RECOVERY CENTER Children First for Oregon PO Box 14914 Portland OR 972930914 943168157 501(c)(3) 11250 CHANGE AGENT SPONSORSHIP EVENTS Clackamas County Health Housing & Human Svcs 2051 Kalen Road 367 Oregon City OR 97045 936002286 Clackamas Cnty 121250 NURSE PLACEMENT IN CRISIS CENTER Community Health Partnership 315 SW 5th Ave Suite 202 Portland OR 97204 931259522 501(c)(3) 25000 CONTRIBUTE TO THE MILK BANK Gladstone Center for Children and Families 17789 Webster Road Gladstone OR 97207 931284265 501(c)(3) 40000 HEALTH CARE PROGRAMS DESIGN Healthcare Coalition of Southern Oregon PO Box 1419 Medford OR 97501 931065133 501(c)(3) 20000 JACKSON COUNTY'S PRENATAL EXPANSION PROGRAM Jefferson Regional Health Alliance 670 Superior CT Ste 108 Medford OR 97504 593813059 501(c)(3) 75000 CLINIC SUPPORT LaClinica Del Valle Family Health Care Ctr 3617 S Pacific Highway Medford OR 97501 943096772 501(c)(3) 26250 SPONSORSHIP OF THE HEALTH EVENT & PRIMARY CARE MEDICAL HOME CLINIC SUPPORT Lifeworks NW 14600 NW Cornell Road Portland OR 97229 930502822 501(c)(3) 29000 ON SITE MENTAL HEALTH & ADDICTIONS $ FUNDRAISING EVENTS Loaves and Fishes Center Inc 7710 SW 31st Ave Portland OR 97219 930584318 501(c)(3) 7472 CARE SUPPORT PILOT PROGRAM & SPONSORSHIP OF ANNUAL EVENT Native American Rehab Assn of the NW 1776 SW Madison Portland OR 97205 237098400 501(c)(3) 50000 OUTREACH & SUBSTANCE ABUSE PROGRAMS Neighborhood Health Center 315 SW 5th Ave Portland OR 97204 273524752 501(c)(3) 4376993 552442 FMV ASSETS, PREPAIDS SUPPORT OPERATING COMMUNITY HEALTH CENTERS TO INCREASE ACCESS FOR HEALTH CARE SERVICES Oregonians for Health Communities Education Fund 7555 SW Hermoso Way 200 Portland OR 97223 200516601 67670 SPONSORSHIP OF CCO COMMUNITY DISCUSSIONS Northwest Health Foundation 221 NW 2nd Suite 300 Portland OR 97209 911854545 501(c)(4) 2585000 INVEST IN OREGON ALLIANCE & EXPANSION OF RELEASING TIME TO CARE PROGRAM Oregon Community Foundation 1221 SW Yamhill ST 108 Portland OR 97205 200195556 501(c)(3) 20000 PREVENTION & WELLNESS HEALTH DEMONSTRATION PROJECT Oregon Health Care Quality Corp 619 SW 11th Suite 221 Portland OR 97205 931293103 501(c)(3) 25059 QUALITY MEASURES FOR OREGON CLINICS Oregon Pediatric Society 4000 Kruse Way PL STE 210 Lake Oswego OR 97035 930672605 501(c)(3) 50000 SUPPORT OREGON PSYCHIATRIC ACCESS LINE FOR KIDS Oregon Primary Care Association 110 SW Yamhill ST 300 Portland OR 97204 930877986 501(c)(3) 125000 IMPROVEMENT ON QUALITY SCORES Outside In 1132 SW 13th Ave Portland OR 97205 930567549 501(c)(3) 50000 OUTREACH PROGRAM The Canby Center 896 S Ivy Canby OR 97013 510603464 501(c)(3) 10000 RECOGNIZE THE SIGNIFICANT ROLE IN SERVING THE INDIVIDUALS IN THE COMMUNITY Tuality Community Hospital PO Box 548 Hillsboro OR 97123 930430029 501(c)(3) 150000 RELEASING TIME TO CARE LEAN PROGRAM Virginia Garcia Memorial Health Center PO Box 568 Hillsboro OR 97113 930717997 501(c)(3) 107215 SUPPORT HEALTH CARE AND DENTAL SERVICES TO THE UNINSURED AND CAREOREGON PATIENTS 21 3 Grant Monitoring Part I, Line 2 Assistance is provided to organizations in our service area that 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 X X X false false false false false false false false false David E Ford 309316 82751 22000 22050 21073 457190 0 Carolyn J Rankin 243572 51188 22000 22050 10240 349050 0 Margaret S Rowland 234401 24833 22000 22050 12042 315326 0 David Labby 212938 22656 22000 21324 10473 289391 0 Patrick J Curran 111870 12959 22000 12955 10385 170169 0 Angela I Uba 126733 0 15866 12981 4341 159921 0 Teresa K Learn 111815 12461 16500 12566 10946 164288 0 Martin P Taylor 136039 0 2787 12542 8435 159803 0 Severance Agreements Schedule J, Part I, Line 4a BOTH DAVID FORD, CEO AND CAROLYN RANKIN, CFO/COO HAVE SEVERANCE AGREEMENTS IN THEIR EMPLOYMENT CONTRACT WITH CAREOREGON. MR. FORD'S SEVERANCE AGREEMENT STATES THAT HIS SEVERANCE SHALL BE AN AMOUNT EQUAL TO TEN MONTHS OF BASE SALARY PAYABLE IN CAREOREGON'S SOLE DISCRETION IN EITHER A LUMP SUM OR AS SALARY CONTINUATION ON A MONTHLY BASIS FOLLOWING MR. FORD'S TERMINATION DATE. MS. RANKIN'S SEVERANCE AGREEMENT STATES THAT HER SEVERANCE IS AN AMOUNT EQUAL TO SIX MONTHS BASE SALARY. NEITHER MR. FORD NOR MS. RANKIN RECEIVED ANY PAYMENTS PURSUANT TO THEIR SEVERANCE AGREEMENTS DURING 2011. SUSAN CLACK MD BOARD DIRECTOR 195619 REFER TO PART V false PHILIP MILLER MD SPOUSE OF BOARD DIRECTOR 58650 REFER TO PART V false Business Transactions Involving Interested Persons Part IV DR. SUSAN CLACK, A CAREOREGON BOARD MEMBER, IS A BOARD MEMBER, CEO AND PROVIDER AT PACIFIC MEDICAL GROUP, WHICH RECEIVED PAYMENTS OF $195,619 FOR HEALTH CARE SERVICES AND QUALITY IMPROVEMENTS. CAREOREGON CONSIDERED ALTERNATIVES TO THIS TRANSACTION AND DR. SUSAN CLACK REFRAINED FROM VOTING THE APPROVAL OF THIS TRANSACTION. THE TRANSACTION AMOUNTS PAID WERE NEGOTIATED AT ARMS LENGTH. DR. PHILLIP MILLER, HUSBAND OF CAREOREGON BOARD MEMBER COLLEEN CAIN, OPERATES A PEDIATRIC CLINIC. THE PEDIATRIC CLINIC RECEIVED PAYMENTS FROM CAREOREGON TOTALING $10,799 FOR HEALTH CARE SERVICES RENDERED. DR. MILLER WAS ALSO EMPLOYED AS A PROVIDER IN ONE OF OUR CLINICS DURING 2011. HE RECEIVED $47,851 IN COMPENSATION AND BENEFITS AS AN EMPLOYEE. CAREOREGON CONSIDERED ALTERNATIVES TO THESE TRANSACTIONS AND COLLEEN CAIN DID NOT VOTE ON THE APPROVAL OF THESE TRANSACTIONS. THE TRANSACTION AMOUNTS PAID WERE NEGOTIATED AT ARMS LENGTH. SUPPLEMENTAL INFORMATION TO 2011 FORM 990 FOR CAREOREGON, INC. CAREOREGON, INC. EIN# 93-0933975 PART I, LINE 1 TAX-EXEMPT PURPOSE AND MISSION OF CAREOREGON: CAREOREGON IS A COMMUNITY BENEFIT ORGANIZATION WHOSE MISSION IS TO ASSURE OREGON'S VULNERABLE POPULATIONS RECEIVE ACCESS TO HIGH-QUALITY HEALTH CARE FROM A STABLE NETWORK BY A WELL-MANAGED, FINANCIALLY SOUND ORGANIZATION. CAREOREGON PROVIDES CARE SUPPORT AND DISEASE MANAGEMENT SERVICES TO HIGH RISK MEMBERS, COORDINATES CARE AND PROVIDES UTILIZATION MANAGEMENT SERVICES, OFFERS CONTINUITY OF COVERAGE FOR THOSE ELIGIBLE FOR MEDICAID AND MEDICARE, SUPPORTS AND ACTIVELY WORKS WITH PROVIDERS TO IMPLEMENT QUALITY IMPROVEMENT EFFORTS AND PRIMARY CARE REDESIGN, CONTRACTS WITH PUBLIC AND PRIVATE PROVIDERS AND WORKS WITH THE LEGISLATURE AND COMMUNITY BASED ORGANIZATIONS TO IMPROVE THE HEALTH OF LOW-INCOME OREGONIANS. PART I, LINE 8-22 CAREOREGON EXPERIENCED A SIGNIFICANT INCREASE IN TOTAL REVENUES AND EXPENSES IN 2011 COMPARED TO 2010. THE INCREASE IN REVENUE WAS PRIMARILY DUE TO INCREASED MEMBERSHIP, HOWEVER THE HOSPITAL REIMBURSEMENT ADJUSTMENT (HRA) REVENUE, WHICH IS WHOLLY PASSED THROUGH TO THE LARGER HOSPITALS, ALSO INCREASED SIGNIFICANTLY OVER THE PRIOR YEAR. MEDICAL COSTS INCREASED FOR THE SAME REASONS: INCREASED MEMBERSHIP AND HRA PASS THROUGH EXPENSE. OFFSETTING SOME OF THE MEDICAL COSTS WAS $9 MILLION IN PREMIUM DEFICIENCY RESERVE AMORTIZATION, REPRESENTING THE CHANGE IN THE PREMIUM DEFICIENCY RESERVE FROM 2010 TO 2011. A $7 MILLION PREMIUM DEFICIENCY RESERVE WAS RECORDED AT DECEMBER 31, 2011 IN ANTICIPATION OF THE LOSSES TO BE INCURRED IN 2012 ON THE EXISTING CONTRACT WITH THE STATE. A PREMIUM DEFICIENCY RESERVE IS RECOGNIZED WHEN IT IS PROBABLE THAT EXPECTED FUTURE MEDICAL CLAIMS, ADMINISTRATIVE COSTS AND INVESTMENT INCOME WILL EXCEED FUTURE REVENUE FOR A GIVEN CONTRACT. WITH NO ABILITY TO MANAGE THE RATES, THE MEDICAL BENEFITS OFFERED, OR WHICH MEMBERS ARE ENROLLED, CAREOREGON IS VULNERABLE TO INCURRING LOSSES AND IS EXPECTED TO DO SO IN 2012. THE INCREASING PRESSURES FROM THE STATE BUDGET ONLY CONTRIBUTE TO THE LIKELIHOOD OF INSUFFICIENT RATES IN THE FUTURE. AS A RESULT, THE COMPANY HAS MAINTAINED NET ASSETS SUFFICIENT TO WITHSTAND THESE INCREASED FINANCIAL RISKS. WITH THESE RESERVES, CAREOREGON IS ABLE TO STRATEGICALLY INVEST IN WAYS TO IMPROVE HEALTH OUTCOMES FOR ITS MEMBERS, IMPROVE ACCESS, INCREASE MEMBER AND PROVIDER SATISFACTION AND REDUCE MEDICAL COSTS, ALL OF WHICH ARE NECESSARY IN ORDER TO PURSUE ITS MISSION. PART III, LINE 4 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS A. WE PROVIDE A MANAGED CARE DELIVERY SYSTEM FOR APPROXIMATELY 158,000 HEALTH PLAN MEMBERS THROUGHOUT THE STATE OF OREGON. AS A MEDICAID MANAGED CARE PLAN, WE PROVIDE ACCESS FOR THE MOST VULNERABLE OF OREGON'S POPULATIONS. OUR WORK INVOLVES CORRDINATING QUALITY HEALTH CARE FOR OUR MEMBERS, CONTRACTING WITH PUBLIC AND PRIVATE PROVIDERS, PROVIDING STABLE FUNDING THAT OUR NETWORKED DOCTORS AND HOSPITALS CAN RELY ON AND CONTROLLING ESCALATING HEALTH CARE COSTS BY PRODIVING CARE COORDINATION AND MEMBER BENEFITS ASSURANCE SERVICES. THESE SERVICES RESULT IN ACCESS TO CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS. B. WE ADMINISTER A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN ON BEHALF OF HEALTH PLAN OF CAREOREGON, A RELATED C CORPORATION TO CAREOREGON. HEALTH PLAN OF CAREOREGON PROVIDES CONTINUITY OF COVERAGE FOR CAREOREGON'S MEMBERS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. THIS BENEFITS BOTH PATIENTS AND PROVIDERS BY ENSURING A COORDINATED AND CONVENIENT MEANS OF RECEIVING AND DELIVERING QUALITY CARE. THE EXPENSES INCURRED BY HEALTH PLAN OF CAREOREGON TO OPERATE THE PLAN TOTAL $107,122,812 WITH RELATED REVENUES OF $116,689,845. C. WE CONTRIBUTED ASSETS AND FUNDS TO FORM A NEW INDEPENDENT 501(c)(3) CORPORATE ENTITY, NEIGHBORHOOD HEALTH CENTER, TO INDEPENDENTLY RUN THE EXISTING CLINIC OPERATIONS AND DENTAL SERVICES TO INCREASE ACCESS TO COMPREHENSIVE AND PREVENTIVE HEALTH CARE SERVICES AND TO IMPROVE HEALTH CARE STATUS OF THE VULNERABLE AND UNDERSERVED POPULATIONS OF THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. WE INVEST IN THE COMMUNITY BY CONTRIBUTING TO OTHER CHARITABLE ORGANIZATIONS THAT ARE STRIVING TO IMPROVE HEALTH CARE IN OREGON. WE ALSO PROVIDE COMMUNITY EDUCATION THROUGH SPONSORSHIP OF PUBLIC SERVICE ANNOUNCEMENTS ON TV AND RADIO RELATED TO BETTER NUTRITION AND INCREASED ACTIVITY. D. WE ENCOURAGE CLINICS TO PROVIDE THE BEST PRIMARY CARE POSSIBLE THROUGH OUR PRIMARY CARE RENEWAL ("PCR") PROGRAM. OUR PCR INITIATIVE FOCUSES ON DEVELOPING PATIENT CENTERED PRIMARY CARE HOMES IN THE PRIMARY CARE SETTING BY BUILDING SYSTEMS AND PROCESSES FOR PROACTIVE PANEL MANAGEMENT, TEAM-BASED CARE, NURSE-LED CASE MANAGEMENT, PATIENT EMPOWERMENT FOR SELF-MANAGEMENT, INTEGRATION OF PHYSICAL AND MENTAL HEALTH CARE, IMMUNIZATION AND DISEASE-SPECIFIC PATIENT REGISTRIES, AND SAME-DAY AND EXTENDED-HOUR MEMBER ACCESS TO THE CARE TEAM. ALL OF THESE IMPROVEMENTS ARE DONE WITH THE GOAL OF COST-EFFECTIVE, CONTINUOUS, COORDINATED CARE. OUR MODEL IS ONE OF LEARNING FOR THE MEMBER; ACTING FOR THE POPULATION. WE PARTICIPATE ACTIVELY IN THE INSTITUTE OF HEALTHCARE IMPROVEMENT'S TRIPLE AIM, A NATIONAL PROGRAM THAT LOOKS AT MAXIMIZING RESULTS IN THREE AREAS: OUTCOME EXCELLENCE, PATIENT SATISFACTION AND COST EFFECTIVENESS. BY CONTINUING TO WORK WITH CLINICS TO IMPROVE THEIR PATIENT-CENTERED MEDICAL HOMES IN 2011, OVER 40% OF OUR MEMBERS BENEFITTED FROM THIS ENHANCED CARE. BASED ON THAT EXPERIENCE, CAREOREGON EXPANDED THE COLLABORATIVE TO A NEW GROUP OF CLINICS (PC3-PATIENT AND POPULATION CENTERED PRIMARY CARE) TO HELP THEM TRANSFORM THEIR PROCESSES, DATA SYSTEMS, AND WORKFORCE TO IMPROVE PATIENT EXPERIENCE AND OUTCOMES. WE FUND CARE SUPPORT AND SYSTEM INNOVATION ("CSSI") PROJECTS TO HELP OUR PROVIDERS FOCUS ON IMPROVING AND TRANSFORMING DELIVERY SYSTEMS AND QUALITY OF CARE FOR OUR MEMBERS. FOLLOWING THE INSTITUTE FOR HEALTH IMPROVEMENT'S "TRIPLE AIM," CSSI PROJECTS ADDRESS PERFORMANCE ON THE THREE DIMENSIONS OF CARE: 1) THE HEALTH OF THE DEFINED POPULATION; 2) THE EXPERIENCE OF CARE; AND 3) THE COST PER CAPITA OF PROVIDING CARE FOR THIS POPULATION. THE FUNDED PROJECTS TARGET PATIENT ACCESS, PATIENT SAFETY, WORKFLOWS, AND REDUCTION OF MEDICAL ERRORS. REDUCING THE LATTER, DECREASES THE RISK TO MEMBERS AND COST FOR TAXPAYERS. THERE WERE 39 PROJECTS FUNDED IN 2011. EIGHTEEN PROJECTS STARTED IN 2010 AND FINISHED IN 2011. TWENTY-ONE NEW PROJECTS STARTED IN 2011. AT OUR ANNUAL CSSI CONFERENCE, PROVIDERS WERE ENCOURAGED TO SHARE THEIR INNOVATIONS WITH OTHERS IN THE COMMUNITY, FURTHER LEVERAGING IMPROVEMENTS FROM THEIR PROJECTS AND HELPING OTHER HEALTH CARE ORGANIZATOINS TO ADOPT SIMILAR IMPROVEMENTS. WE PROVIDE TRAINING AND DEVELOPEMENT SUPPORT FOR OUR CSSI TEAMS BY EDUCATING THEM IN ACCELERATED PROCESS IMPROVEMENT AND LEAN METHODOLOGIES. THIS HELPS CREATE EFFICIENCIES IN THE DELIVERY SYSTEM AND PROVIDES SOME RELIEF FOR THE ONGOING CHALLENGES FACED BY THESE UNDERSERVED POPULATIONS. THE TRAINING TAKES PLACE IN OUR DEDICATED LEARNING SPACE, REFERRED TO AS THE LEARNING COMMONS, ENABLING AN ON-GOING FOCUS ON LEARNING AND IMPROVING THE QUALITY OF HEALTH CARE IN THE COMMUNITY. IN 2011, WE ALSO EXPANDED RELEASING TIME TO CARE. THIS IMPROVEMENT METHODOLOGY DESIGNED BY NURSES FOR USE IN A HOSPITAL SETTING USES LEAN TECHNIQUES TO ELIMINATE WASTEFUL PROCESSES, EXCESS SUPPLIES, AND INTERRUPTIONS SO THAT NURSES CAN SPEND MORE TIME WITH PATIENTS. IN ADDITION TO WORKING WITH THE FOUR OREGON HOPSITALS THAT LAUNCHED THE PROGRAM IN 2010, IN 2011, CAREOREGON MADE PLANS TO TRAIN EIGHT MORE HOSPITALS FROM ALASKA, CANADA, OREGON AND CALIFORNIA. CAREOREGON HAS BECOME THE NORTH AMERICAN FACILITATOR OF THIS PROGRAM, ORIGINATED BY BRITAIN'S NATIONAL HEALTH SERVICE INSTITUTE FOR INNOVATION AND IMPROVEMENT. IN AREAS WHERE HEALTH CARE ACCESS FOR OUR MEMBERS IS INADEQUATE, WE WORK WITH COMMUNITY LEADERS TO EXPAND ACCESS. FOR EXAMPLE, IN THE EAST MULTNOMAH COUNTY COMMUNITY OF ROCKWOOD, WE PURCHASED AND RENOVATED A CLINIC BUILDING SO THAT THE MULTNOMAH COUNTY HEALTH DEPARTMENT COULD PROVIDE MUCH NEEDED PRIMARY CARE TO THIS UNDERSERVED AREA. WE ALSO STARTED THREE PRIMARY CARE CLINICS, A DENTAL CLINIC AND A MOBILE DENTAL VAN AS MENTIONED ABOVE, IN ORDER TO IMPROVE ACCESS FOR OUR MEMBERS AND THE UNINSURED. WE WORK WITH THE LEGISLATURE AND COMMUNITY BASED ORGANIZATIONS TO EDUCATE OTHERS ON THE NEEDS OF LOW-INCOME OREGONIANS AND TO MOVE BILLS AND MEASURES FORWARD THAT IMPROVE THE HEALTH OF LOW-INCOME OREGONIANS. PART IV, LINE 12/12A FOR THE YEAR ENDED DECEMBER 31, 2011, AN AUDIT WAS PERFORMED ON THE CONSOLIDATED ENTITY WHICH INCLUDES CAREOREGON AND HEALTH PLAN OF CAREOREGON. PART VI, LINE 2 MARGARET S. ROWLAND, MD, CHIEF MEDICAL OFFICER OF CAREOREGON, INC., SERVES AS A MEMBER OF THE BOARD OF DIRECTORS OF ALBERTINA KERR. CHRIS KRENK, CHIEF EXECUTIVE OFFICER OF ALBERTINA KERR, SERVES ON CAREOREGON'S BOARD OF DIRECTORS. PART VI, LINE 4 CAREOREGON AMENDED AND RESTATED ITS ARTICLES OF INCORPORATION TO EXPAND THE SCOPE OF ELIGIBLE RECEIVING ORGANIZATIONS IN THE CASE OF DISSOLUTION OR LIQUIDATION. PART VI, LINE 11A CAREOREGON'S FORM 990 IS REVIEWED BY THE CFO, BOARD OF DIRECTORS AND THE AUDIT, FINANCE, AND COMPLIANCE COMMITTEE BEFORE IT IS FILED. THE FORM 990 IS DISCUSSED IN DETAIL AT THE AUDIT, FINANCE, AND COMPLIANCE COMMITTEE MEETING IN SEPTEMBER. 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 THE CONFLICT OF INTEREST POLICY OF CAREOREGON IS DISTRIBUTED ANNUALLY AND APPLIES TO THE FOLLOWING COVERED PERSONS: ANY DIRECTOR, CEO, CMO, CFO, CONTROLLER, OTHER KEY EMPLOYEE OR ANY OTHER INDIVIDUAL IN A POSITION TO EXERCISE SIGNIFICANT INFLUENCE OVER A DECISION HAVING ECONOMIC IMPLICATIONS FOR CAREOREGON. THE CONFLICT OF INTEREST POLICY IS REVIEWED AND DISCUSSED AT AN ANNUAL BOARD MEETING AND EACH PERSON SIGNS AN AGREEMENT TO FOLLOW THE POLICY. CAREOREGON ANNUALLY CIRCULATES QUESTIONNAIRES TO COVERED PERSONS TO DETERMINE INDEPENDENCE AND DISCOVER FAMILY AND BUSINESS RELATIONSHIPS, AND THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE DILIGENTLY REVIEWS THESE FORMS AND COMPILES AND MAINTAINS A LIST OF POTENTIALLY CONFLICTED ENTITIES AND INDIVIDUALS. THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE CONTINUALLY MONITORS PROPOSED OR ONGOING TRANSACTIONS AGAINST THIS LIST AS A MEANS OF IDENTIFYING AND SCREENING FOR POSSIBLE CONFLICTS. THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE DEALS WITH POTENTIAL OR ACTUAL CONFLICTS, BEFORE, DURING AND/OR AFTER THE TRANSACTION HAS OCCURRED, DEPENDING ON THE CIRCUMSTANCES OF THE CONFLICT. ALL SIGNED CONFLICT OF INTEREST POLICIES AND QUESTIONNAIRES ARE RETAINED AT CAREOREGON'S OFFICE. IN THE EVENT OF A POTENTIAL CONFLICT OF INTEREST, A COVERED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OF DIRECTORS,MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND TO EXECUTIVE OFFICERS WHO ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. FOLLOWING THE DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE LEAVES THE MEETING WHILE THE BOARD OR COMMITTEE INDEPENDENTLY DISCUSSES AND VOTES ON THE MATTER BEFORE IT. IN THE EVENT THAT A CONFLICT IS IDENTIFIED, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER CAREOREGON CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE, THE BOARD OR COMMITTEE SHALL DETERMINE BY MAJORITY VOTE OF THE DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN CAREOREGON'S BEST INTEREST. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS ABOUT THE TRANSACTION. PART VI, LINE 15A AND 15B COMPENSATION MARKET DATA 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 AND DOCUMENTED IN THE MINUTES. THE BOARD APPROVES THE COMPENSATION OF ALL OTHER EMPLOYEES AS PART OF THE BUDGET APPROVAL PROCESS DURING A BOARD MEETING. 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 CFO ABSENT FROM THE MEETINGS, EACH YEAR THE BOARD APPROVES THE SALARY OF THE CEO. THE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. THIS PROCESS WAS LAST UNDERTAKEN ON MAY 13, 2011. PART VI, LINE 18 AND 19 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 5 UNREALIZED GAINS: 1,717,215 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Colleen A. Cain TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Susan M. Clack, MD TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Christopher J. Krenk TITLE:Chairman HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lynnwood R. Lundquist TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Bart McMullan, JR., MD TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gilles M. Munoz TITLE:Vice Chairman HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Vickie S. Gates TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Nathalie Johnson TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mylia Christensen TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Stewart TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David E. Ford TITLE:CEO, President, Board Director HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Beth deHamel TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James A. Diegel TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Amit R. Shah TITLE:Board Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carolyn J. Rankin TITLE:CFO, COO, Board Sec. & Treas. HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Margaret S. Rowland TITLE:Chief Medical Officer HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David Labby TITLE:Director of Clinical Learning HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Patrick J. Curran TITLE:Director of Medicare & Busines HOURS:16 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Angela I. Uba TITLE:Physician HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Teresa K. Learn TITLE:Controller HOURS:9 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Martin P. Taylor TITLE:Public Policy Director HOURS:8 Care Access LLC 315 SW Fifth Avenue Suite 900 Portland OR 97204 270630449 Medical Bldg OR 32288 3259388 NA CareOregon Community Health LLC 315 SW Fifth Avenue Suite 900 Portland OR 97204 272429270 Med Clinic OR 1616614 813676 NA HEALTH PLAN OF CAREOREGON INC 315 SW FIFTH AVENUE SUITE 900 PORTLAND OR 97204 202161234 Medicare OR NA C CORP 9451621 49830197 1.00000 false false false false false false false false false false true false true false false true false false Health Plan of CareOregon K 5829486 actual costs Health Plan of CareOregon M 3145751 actual costs Health Plan of CareOregon P 112409 reimbursements