Oregon Health Authority

Emergency Messages as of 6:00 PM, Mon. Oct 19

No information currently posted.

Subscribe to receive FlashAlert messages from Oregon Health Authority.

Manage my existing Subscription

News Release

Oregon Health Plan Rates For 2027 Released - 10/19/26

October 19, 2026

Contact: Franny White, franny.l.white@oha.oregon.gov, 971-349-3539

Oregon Health Plan rates for 2027 released

SALEM, Ore. – Oregon Health Authority (OHA) and the 15 coordinated care organizations (CCOs) that facilitate Medicaid health benefits in Oregon have successfully worked together to confirm 2027 rates for the Oregon Health Plan (OHP) that will keep healthcare accessible statewide.

Next year, CCOs will collectively receive an average of 6.1% more per member per month compared to this year.

“Oregon Health Authority remains focused on ensuring people enrolled in the Oregon Health Plan can receive quality healthcare well into the future,” said OHA Chief Financial Officer Rochelle Layton. “Our updated 2027 rates support the financial stability of the coordinated care organizations that help us deliver Medicaid benefits across the state.”

OHP covers about 1.4 million people, including low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is administered by states according to federal requirements, and the program is jointly funded by states and the federal government.

OHA contracts with CCOs to coordinate regional healthcare needs for the vast majority of OHP members. OHA primarily pays CCOs through per-member-per-month payments, which are also known as capitation rates. 

Multiple factors were considered during the 2027 rate-setting process, including people losing coverage due to upcoming federal changes, rising healthcare costs, and ongoing changes to covered benefits and payment policies. State and federal rules require CCO rates to be designed to deliver enough revenue to cover expected costs.

When discussing 2027 rates, OHA is separating out the state’s one-time financial investment in maternity care, which temporarily increased CCO payments in 2026. Showing next year’s overall CCO rates without maternity care enables more accurate rate comparisons over time.

Without the maternity care payments, Oregon CCOs will receive an average of 6.1% more per member per month next year. However, when maternity payments are included, 2027 rates increase an average of 5.6% over 2026. As a result, CCOs will receive an average of $627.68 per member per month in 2027 to coordinate the medical, dental, and behavioral healthcare services for most of the state’s Medicaid enrollees next year.

OHA developed 2027 rates after analyzing CCO financial data from 2025 and early 2026. As was reported earlier, Oregon CCOs collectively had a profit margin of 0.8% in 2025, which was an improvement from just 0.001% in 2024. Preliminary data for early 2026 indicates CCO finances have continued to improve.

During the 2027 rate-setting process, OHA increased its collaboration with CCOs and improved public transparency as required by Oregon House Bill 4039, which became law in March and directed OHA to use a more transparent, data-driven process while developing CCO rates. OHA staff gave two Oregon Health Policy Board presentations before rates had been finalized, increased the amount of time CCOs had to review draft rates, met with CCOs more often during the rate-setting process, and released additional exhibits required by the new law.

OHA has submitted the proposed 2027 CCO rates to the U.S. Centers for Medicare & Medicaid, which is expected to approve them by the end of this calendar year. For more information, see the draft 2027 CCO capitation rate development & certification report.

###

Oregon Health Plan Rates For 2027 Released - 10/19/26

October 19, 2026

Contact: Franny White, franny.l.white@oha.oregon.gov, 971-349-3539

Oregon Health Plan rates for 2027 released

SALEM, Ore. – Oregon Health Authority (OHA) and the 15 coordinated care organizations (CCOs) that facilitate Medicaid health benefits in Oregon have successfully worked together to confirm 2027 rates for the Oregon Health Plan (OHP) that will keep healthcare accessible statewide.

Next year, CCOs will collectively receive an average of 6.1% more per member per month compared to this year.

“Oregon Health Authority remains focused on ensuring people enrolled in the Oregon Health Plan can receive quality healthcare well into the future,” said OHA Chief Financial Officer Rochelle Layton. “Our updated 2027 rates support the financial stability of the coordinated care organizations that help us deliver Medicaid benefits across the state.”

OHP covers about 1.4 million people, including low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is administered by states according to federal requirements, and the program is jointly funded by states and the federal government.

OHA contracts with CCOs to coordinate regional healthcare needs for the vast majority of OHP members. OHA primarily pays CCOs through per-member-per-month payments, which are also known as capitation rates. 

Multiple factors were considered during the 2027 rate-setting process, including people losing coverage due to upcoming federal changes, rising healthcare costs, and ongoing changes to covered benefits and payment policies. State and federal rules require CCO rates to be designed to deliver enough revenue to cover expected costs.

When discussing 2027 rates, OHA is separating out the state’s one-time financial investment in maternity care, which temporarily increased CCO payments in 2026. Showing next year’s overall CCO rates without maternity care enables more accurate rate comparisons over time.

Without the maternity care payments, Oregon CCOs will receive an average of 6.1% more per member per month next year. However, when maternity payments are included, 2027 rates increase an average of 5.6% over 2026. As a result, CCOs will receive an average of $627.68 per member per month in 2027 to coordinate the medical, dental, and behavioral healthcare services for most of the state’s Medicaid enrollees next year.

OHA developed 2027 rates after analyzing CCO financial data from 2025 and early 2026. As was reported earlier, Oregon CCOs collectively had a profit margin of 0.8% in 2025, which was an improvement from just 0.001% in 2024. Preliminary data for early 2026 indicates CCO finances have continued to improve.

During the 2027 rate-setting process, OHA increased its collaboration with CCOs and improved public transparency as required by Oregon House Bill 4039, which became law in March and directed OHA to use a more transparent, data-driven process while developing CCO rates. OHA staff gave two Oregon Health Policy Board presentations before rates had been finalized, increased the amount of time CCOs had to review draft rates, met with CCOs more often during the rate-setting process, and released additional exhibits required by the new law.

OHA has submitted the proposed 2027 CCO rates to the U.S. Centers for Medicare & Medicaid, which is expected to approve them by the end of this calendar year. For more information, see the draft 2027 CCO capitation rate development & certification report.

###