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@OHAOregon
January 10, 2022
Contact: Philip Schmidt (503)383-6079
The Oregon Health Authority (OHA) notified Trillium Community Health Plan (Trillium) last week that due to progress made on its corrective action plan, the coordinated care organization could begin enrolling members in the Tri-County area again. Trillium had been suspended from enrolling new members in December 2021, due to continued non-compliance with provisions of the corrective action plan.
OHA noted that Trillium had made sufficient progress on portions of the following findings of non-compliance in the corrective action plan, though certain actions within the findings remain open.
Read the letter OHA sent to Trillium.
Read the appendix to the letter, summarizing the action plan steps.
Background:
Trillium was placed on a Corrective Action Plan (CAP) in September of 2020, concurrent with its entry into the Tri-County service area. The CAP was imposed after Trillium’s failure to adequately address OHA’s concerns around the plan’s expansion into the Tri-County service area. The CAP was comprised of four main finding areas: network development, health equity & language access, community engagement, and intensive care coordination (ICC). Between October 2020 and February 2021, Trillium and OHA collaborated to develop action areas sufficient to address OHA’s concerns regarding each of the four CAP findings.
In a Nov. 1, 2021 Notice, OHA notified Trillium of continued non-compliance with minimal progress towards correcting the violations set forth in the Sep. 2, 2020 Notice. The CAP was extended for an additional period of at least six months (through March 2022). OHA elected to impose additional Sanctions until Trillium resolved the violations set forth in the Nov. 1, 2021 Notice. Effective Dec. 1, 2021, OHA suspended all new enrollment, including automatic enrollment, in Trillium’s Tri-County service area. The Nov. 1, 2021 Notice outlined the CAP findings requiring resolution within three (3) months of issuance.
About coordinated care organizations
Oregon first established CCOs in 2012 to transform health care delivery in the state. CCOs bring together physical, behavioral, and oral health providers to coordinate care for people on the Oregon Health Plan. They improve health and reduce costs by providing more coordinated, flexible and innovative services. CCOs are rewarded for achieving specific health outcomes and quality measures.
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