The Coordinated Care Organization serving Lane County may soon be sold to a Fortune 500 Company.
If the sale goes through, members of the Trillium Community Health Plans will receive services operated by the St. Louis-based Centene Corporation, which would start receiving state Medicaid funds.
The Oregon Health Plan provides low-income Oregonians with healthcare services. As part of this Medicaid program, the state gives money to Coordinated Care Organizations: private companies or non-profits that aim to offer a streamlined network of medical services to their patients. The companies use this state money to pay for services – which range from preventative-care checkups to mental health treatment – along with administrative fees. Whatever is left over is profit.
Trillium is the only CCO in Lane County, and it has grown profitable, netting $22 million last year (a 550% increase from the previous year's $4 million), according to the Register-Guard. Now, Centene wants to buy Trillium's parent company (doctor-owned Agate Resources) for around $100 million.
Before the sale can go through it must be approved by the Oregon Insurance Division, and some residents of Lane County are apprehensive about the notion of selling a community-run healthcare provider to a company from out-of-state.
"I don't think we like to think of health care and Medicaid as for-profit" said Diane Lund, executive editor of health news source the Lund Report. She says locals are worried about taxpayer dollars leaving the state "and enhancing Centene's bottom line," rather than serving patients.
Terry Coplin, CEO of both Trillium and Agate, defended the proposed sale, saying Centene provides "a significant amount of infrastructure we're going to need... to really make the Coordinated Care Organization function the way it's supposed to function."
“It would take us up to five years to build the infrastructure we could get within one year with an affiliation with Centene, and by the time you build that infrastructure it's probably already out of date.”
Lund agreed that a large company like Centene can provide numerous assets a CCO might not otherwise have, but questioned the dedication of such companies to local patient care.
"You don't have the same trust," she said. "You don't know who's doing what. If... physicians [own the] company, they're looking out for your best interest in the long run. But why would a CEO who's making $19 million? Why do they really care?"
"And what about the accountability? How accountable is an organization that's run out of St. Louis?" she added.
Coplin says he understands the anxiety, but says Centene's ownership cannot result in any reduction in services: "The benefits... the way we deliver care, much of that is already defined, and we are bound by contract and by rule to carry those out. Those can't be changed."
The deal is now in the hands of Oregon Commissioner of Insurance, Laura Cali, who will take public comment before deciding whether to allow the sale to go through.
The Insurance Division is accepting public comment until Friday, June 12th at 5 p.m. Find out how to submit your comment here.