Oregon Medicaid director outlines program scope, recent 1115 waivers and expansion efforts

Emma Sandow, director of Oregon Medicaid, told the Senate Committee on Early Childhood and Behavioral Health Tuesday that Medicaid is central to state health policy and covers about 1.4 million people in Oregon.

Sandow summarized how Medicaid differs from Medicare and described Oregon’s delivery system, which uses coordinated care organizations or CCOs for roughly 92 percent of members and fee‑for‑service for about 7.5 percent (including some tribal members, youth in child welfare and certain other groups). She said coordinated care organizations receive a per‑member payment and are responsible for coordinating care and financial risk for their enrollees.

Sandow outlined Oregon’s use of Section 1115 waivers of the Social Security Act to expand coverage and benefits. She described two 1115 waivers in Oregon: a broad, long‑standing waiver the presentation referred to as the "big 1115 waiver," and a newer waiver…