Understanding the Oregon Health Plan and Coordinated Care Organizations

If you have Oregon Health Plan (OHP) insurance, you might wonder how it all works. The short answer: OHP members get care through Coordinated Care Organizations (CCOs). CCOs are networks of providers that help you get the services you need.

Neighborhood Health Center (NHC) partners with several CCOs in our region, which means we can be your clinic if you choose. Here’s how the system works and why choosing your own clinic matters.

What is a Coordinated Care Organization (CCO)?

A Coordinated Care Organization, or CCO, is like the coach of your healthcare team. Instead of your doctor, dentist, counselor, and pharmacist all working separately, a CCO makes sure they share information and work together.

What CCOs do for you:

  • Coordinate your care so your providers are on the same page.

  • Cover many types of care, including physical, mental, behavioral, and sometimes dental.

  • Stay local by serving specific regions of Oregon and connecting you to community resources.

  • Focus on prevention so you get regular check-ups and screenings to stay healthy.

Why it matters: When your providers work as a team, you get better care, avoid unnecessary ER visits, and feel more supported. For example, if your doctor notices signs of depression, your CCO helps connect you with counseling.

a map of coordinated care organizations in oregon

CCOs in NHC's Service Area 

If you live in NHC's service area, you might be assigned to one of these CCOs: 

NHC works with all three of these coordinated care organizations in Oregon, which means we can be your clinic no matter which CCO you're assigned to. That may not be the case with every FQHC. 

How Does the CCO Assignment Process Work? 

When you get approved for the Oregon Health Plan, here's what happens: 

Step 1: Automatic CCO Assignment 

As you begin the process, you will be asked to select your preferred CCO.  

If you do not make a selection, the state will review your home address and assign you to a CCO that serves your area. You don't get to choose this part – it's done automatically based on where you live. However, if more than one CCO operates in your area, you can change your CCO. There may be a wait period as the change happens. But you’ll still be covered by your old CCO in the meantime. 

Step 2: Clinic Assignment 

Once you're assigned to a CCO, that organization assigns you to a clinic or primary care doctor within its network. This is where things get important. 

Step 3: The Choice is Yours (If You Act Fast) 

Here's the key thing many people don't know: If you don't choose a provider or clinic yourself, one will be picked for you. The clinic they choose might not be close to your home, might not offer the services you need, or might not feel like the right fit. 

That's why it's smart to choose your CCO with OHP instead of letting someone else decide for you. 

person walking into a federally qualified health center

Why Choosing the Right Clinic Matters 

Picking your own clinic instead of being assigned randomly gives you several important benefits. Here’s how you can find an OHP clinic that works best for you: 

You Get More Control 

When you choose your clinic, you're making an active decision about your health care. You can be sure you pick a place that: 

  • Is close to your home or work 
  • Offers the services you need 
  • Works for you and any other covered family members 
  • Feels comfortable and welcoming to you 

Better Coordinated Care 

When you stay with one clinic, your care team gets to know you. They understand your health history, your concerns, and your health goals. This means: 

  • Less time repeating your medical history 
  • Better communication between your doctors to streamline your care 
  • More personalized care plans 

Long-Term Relationships Matter 

Building a relationship with your care team takes time, but it's worth it. When your doctors and nurses know you well, they can: 

  • Spot health changes earlier 
  • Provide better preventive care 
  • Help you manage chronic conditions more effectively 
  • Manage your prescriptions carefully 
  • Support you through any new health challenges 

Integrated Services at NHC 

At NHC, we offer many services, including: 

  • Medical care such as regular check-ups, sick visits, and chronic disease management 
  • Dental care, including cleanings, fillings, and other dental services 
  • Behavioral health, like mental health support and personalized strategy development
a dentist and a dental assistant working on a patient

How to Choose NHC as Your Clinic 

If you want NHC to be your primary care clinic, here's how to make it happen: 

Check Your CCO First 

Make sure NHC works with your CCO. We're in-network with: 

  • Trillium Community Health Plan 
  • Health Share of Oregon (CareOregon Medical Plan only) 
  • Pacific Source Community Solutions (Accepted at Canby location only) 
  • Yamhill Community Care  
  • Columbia Pacific CCO 
  • Capitol Dental 
  • Moda Dental  
  • ODS Community Dental

Ways to Request NHC 

Option 1: Call OHP Client Services 

  • Phone: 1-800-699-9075 
  • Tell them you want to choose NHC as your clinic 
  • Have your OHP ID number ready 

Option 2: Call Your CCO's Member Services 

  • Trillium: 1-877-600-2054 
  • Health Share: 1-800-919-1481 
  • Pacific Source: 1-800-431-4135 
  • Request NHC as your primary care clinic 

Option 3: Ask NHC for Help 

  • Call any NHC location 
  • Our staff can help you through the process 
  • We'll make sure all the paperwork gets handled correctly 

Important: Have Your Information Ready 

When you call, make sure you have: 

  • Your OHP ID number (from your member card or welcome packet) 
  • Your full name and date of birth 
  • Your current address 
a nurse practitioner checking a patient's ear

Can You Change CCOs or Clinics Later? 

Yes! You have options if you need to make changes: 

Changing Clinics 

  • You can change your clinic or primary care provider anytime 
  • No waiting periods or special enrollment times needed 
  • Just call your CCO's member services line or OHP Client Services 

Changing CCOs 

Changing CCOs is a bit more limited: 

  • Change during open enrollment, which usually happens once a year 
  • For specific reasons like a move to a new area, if your current CCO stops serving your area, or if you need services your current CCO doesn't offer 

Note: You are not officially an NHC patient until you schedule a new patient appointment so your provider can get to know you. So be sure to make that appointment right away. 

Not Sure Who Your CCO or Clinic Is? 

If you're confused about your current setup, here's how to find out: 

Check Your Paperwork 

Look for: 

  • Your OHP member card (shows your CCO) 
  • Welcome packet from when you first got approved 
  • Any letters from your CCO 

Call to Get Help With the Process 

  • OHP Client Services: 1-800-699-9075 
  • They can tell you which CCO you're assigned to and which clinic 

Ask NHC For Help 

Even if you're not currently our patient, we can help you figure out: 

  • Which CCO are you assigned to 
  • Whether we're in-network with your CCO 
  • How to make the switch if you want NHC as your clinic 

How NHC Can Help You Navigate the System 

Understanding the Oregon Health Plan CCO system doesn’t have to be overwhelming. NHC has Certified Enrollment Assistors who are specially trained to help with: 

Enrollment Support 

  • Help you understand your benefits 
  • Guide you through choosing or changing your clinic 
  • Make sure you're getting all the services you're entitled to 

Language Support 

  • Bilingual staff available 
  • Translation services for appointments 
  • Materials available in different languages 

Step-by-Step Guidance 

  • We walk you through every part of the process 
  • Answer your questions in plain language 
  • Follow up to make sure everything goes smoothly 

Ongoing Support 

Our Member Enrollment Services (MES) team is here to help not just when you first enroll, but anytime you have questions about your coverage or need to make changes. 

Ready to Get Started? 

If you're ready to choose NHC as your clinic or need help understanding your Oregon Health Plan options, we're here to help. Whether you need to find an OHP clinic for the first time or change your current provider, contact us today, and our team will guide you through the process of making sure you get the coordinated, personalized care you deserve.