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Providers and committee press CCOs for before‑and‑after data after OHP network change
Summary
Committee members and local therapists told the advisory committee that recent OHP/CCO network changes have reduced youth access to care; members requested CPCCO/CCO claims data from before and after an October 1 policy change and heard that claims snapshots may change over time.
Members of the Human Services Advisory Committee pressed county staff and CCO representatives for clearer program data after recent policy changes affecting Oregon Health Plan (OHP) network participation led local providers to report lost access for children.
CPCCO staff explained that the member data presented earlier were claims pulled at a particular point in time and therefore reflect a snapshot: “The member data is from claims that were pulled at a specific point in time. The numbers aren't static because of the nature of claims submission,” staff said. Committee members asked for comparative claims data (for example, September figures and the months after the October 1 change) to understand the scale of impact on youth access.
Local private practitioners described how the change affected their practices. Amber Bowman said she had been serving 14 youth on OHP before the policy shift, noting the CareOregon presentation earlier said 11 youth were impacted; 9 of Amber’s 14 clients continued privately and 5 relied on reduced‑fee care. She said the administrative process to join CCO networks is onerous and frequently unsuccessful, and clarified that the COA (certificate of approval) process is aimed at organizations with associate‑level providers, not small private practices: “The COA process is … for organizations that employ associate level providers… I don't have anyone working for me that's an associate level, so I don't need a COA.”
CBH responded that it does have capacity in child‑and‑family services and that it is recruiting and adjusting to meet community need; CBH noted it currently has several full‑time child clinicians and a child psychiatrist with availability. At the same time, private practitioners and some committee members said families often prefer to stay with established private providers and may pay out‑of‑pocket to continue care.
Committee members and staff agreed on next steps: ask the CPCCO/CCO to produce claims figures comparing the period before the October 1 change and the period after, and to share dashboard links or other data already publicly available. Members were advised to escalate unresolved individual cases to the ombudsman if the CCO response is unsatisfactory.
No formal action was taken at the meeting to change county policy; the committee recorded the request for comparative data and signaled continued oversight and advocacy on access issues.
