Coordinated care organizations and traditional health worker liaisons

Coordinated care organizations (CCOs) serve people who receive health care coverage under the Oregon Health Plan (Medicaid). Each CCO is now required to employ a traditional health worker (THW) liaison. THW liaisons work in collaboration with the community, the CCO and the THW workforce, which includes birth doulas.

Although the Oregon Health Plan (OHP) fee-for-service rate for THW birth doulas is $150 for a birth and $50 per prenatal and postpartum support visit (possible total of $350), some CCOs are now offering higher rates that fall between $700 and $900.

Some CCOs may require THW birth doulas to become contracted providers in order to access higher rates. While this may require additional time and paperwork, the CCO will list contracted providers (including THW birth doulas) in its directory, which can lead to more referrals. Learn more about your CCO’s approach by contacting the THW liaison.

CCO
Advanced Health

Serves OHP (Medicaid) clients in: Coos and Curry counties

Who is the THW liaison? According to the 2021 member handbook, you can call the THW liaison at 541-269-7400. Advanced Health told us that the CCO has "an internal contact available for THWs."

Can individual THW birth doulas bill Advanced Health for their services, without a contract? No. THW birth doulas would need to be credentialed by Advanced Health, which is part of the contracting process.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Advanced Health declined to answer this question directly. However, the CCO said it does not currently have any credentialed THW birth doulas.

AllCare CCO

Serves OHP (Medicaid) clients in: Curry, Jackson, Josephine and Douglas (partial) counties

Who is the THW liaison? Email contracts@allcarehealth.com.

Can individual THW birth doulas bill AllCare for their services, without a contract? Yes.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Yes, but the THW birth doula must have a contract with AllCare. For 2 prenatal visits, labor support and 2 postpartum visits, AllCare is offering contracted THW birth doulas $850. The rate for individual support visits is $121, and the rate for labor support is $366.

Other support: AllCare has trained some THW birth doulas on how to bill, establish NPI numbers and navigate referral processes.

CareOregon

CareOregon owns two CCOs, Jackson Care Connect and Columbia Pacific, and operates a Health Share of Oregon plan.

Serves OHP (Medicaid) clients in: Jackson Care Connect CCO serves Jackson County and Columbia Pacific CCO serves Clatsop, Columbia and Tillamook counties. The CareOregon plan through Health Share of Oregon serves Clackamas, Multnomah and Washington counties.

Who is the THW liaison? Jackson Care Connect CCO's THW liaison is Cliff Juno (junoc@careoregon.org). Columbia Pacific CCO is in the process of recruiting a THW liaison.

Can individual THW birth doulas bill a CareOregon CCO for their services, without a contract? Yes.

Do the CCOs reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Yes. CareOregon declined to share the reimbursement rate, but it is between $700 and $900 for 2 prenatal visits, labor support and 2 postpartum visits. CareOregon established this rate on Aug. 1, 2020. Contact the CCO for more information.

Who is eligible for the higher rate? Any THW birth doula who is serving Medicaid clients enrolled in a plan through Jackson Care Connect, Columbia Pacific or a CareOregon plan through Health Share of Oregon.

Cascade Health Alliance

Cascade Health Alliance did not provide responses to questions and none of the doulas we interviewed reported working with the CCO.

Serves OHP (Medicaid) clients in: Klamath County (partial)

Who is the THW liaison? On its website, Cascade Health Alliance lists Candice Holohan, who can be reached at 541-883-2947.

Can individual THW birth doulas bill Cascade Health Alliance for their services, without a contract? Unknown.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Unknown.

Who is eligible for the higher rate? Unknown.

Eastern Oregon CCO

Eastern Oregon CCO did not provide responses to questions and none of the doulas we interviewed reported working with the CCO.

Serves OHP (Medicaid) clients in: Baker, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa and Wheeler counties

Who is the THW liaison? Contact Sherrie Grieef at sherrie.grieef@eocco.com or 541-408-6826 for questions about working with Eastern Oregon CCO.

Can individual THW birth doulas bill Eastern Oregon CCO for their services, without a contract? Unknown.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Unknown.

Who is eligible for the higher rate? Unknown.

Health Share of Oregon

Serves OHP (Medicaid) clients in: Clackamas, Multnomah and Washington counties

Who is the THW liaison? Health Share of Oregon is in the process of training Ayni Amir, who can be reached at amira@healthshareoregon.org, as a THW liaison.

Health Share of Oregon has five plans: CareOregon, Kaiser Permanente, Legacy Health PacificSource, OHSU Health and Providence Health Assurance. Depending on what plan your client is using, you may be directed to another THW liaison or contact.

Can individual THW birth doulas bill for their services, without a contract? This depends on the plan.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? This depends on the plan. For example, CareOregon offers a rate between $700 and $900 to all certified THW birth doulas and Providence Health Assurance said it plans to offer a higher rate than the FFS package.

PacificSource Community Solutions

PacificSource Community Solutions owns four CCOs named after the regions they serve: Columbia Gorge, Central Oregon, Marion Polk and Lane. The company also operates a Health Share of Oregon plan called Legacy Health PacificSource.

Serves OHP (Medicaid) clients in:

Central Oregon: Crook, Deschutes, Jefferson and Klamath (partial) counties

Columbia Gorge: Hood River and Wasco counties

Marion Polk: Marion and Polk (partial) counties

Lane: Lane County

Legacy Health PacificSource: Clackamas, Multnomah and Washington (partial) counties


Who are the THW liaisons?

Central Oregon: Tanya Nason (Tanya.Nason@pacificsource.com)

Columbia Gorge: Kate Karlson (Kate.Karlson@pacificsource.com)

Marion Polk: Todd Santiago (Todd.Santiago@pacificsource.com)

Lane: Iris Bicksler (Iris.Bicksler@pacificsource.com)


Can individual THW birth doulas bill for their services, without a contract? Yes.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Yes. PacificSource Community Solutions declined to share the exact reimbursement rate. Doulas who are not affiliated with the CCOs cited a rate between $700 and $900. Contact the CCOs for more information.

Who is eligible for the higher rate? Any certified THW birth doula who is serving Medicaid clients enrolled in a plan through PacificSource Community Solutions’ CCOs.

InterCommunity Health Network CCO (IHN-CCO)

Serves OHP (Medicaid) clients in: Benton, Lincoln and Linn counties

Who is the THW liaison? Contact Stephanie Jensen at stjensen@samhealth.org for questions about working with InterCommunity Health Network. The person in this role may change.

Can individual THW birth doulas bill for their services, without a contract? Yes.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Yes. IHN-CCO declined to share the exact reimbursement rate, but it is between $700 and $900.

Who is eligible for the higher rate? Any certified THW birth doula who is serving Medicaid clients enrolled in a plan through IHN-CCO and who work with the Community Doula Program.

Trillium CCO

Trillium did not provide responses to questions, but several doulas we interviewed reported working with the organization.

Serves OHP (Medicaid) clients in: Lane, Douglas (partial) and Linn (partial) counties

Who is the THW liaison? According to the 2021 member handbook, you can contact Massarra Eiwaz-Ransomn at 1-877-600-5472 and THW@TrilliumCHP.com.

Can individual THW birth doulas bill for their services, without a contract? Unknown.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Yes.

Who is eligible for the higher rate? Unknown.

Umpqua Health Alliance

We could not reach an Umpqua Health Alliance spokesperson and none of the doulas we interviewed reported working with the organization.

Serves OHP (Medicaid) clients in: Douglas County

Who is the THW liaison? According to the 2020 member handbook, you can call 541-673-1462 for THW assistance through Umpqua Health Alliance.

Can individual THW birth doulas bill for their services, without a contract? Unknown.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Unknown.

Who is eligible for the higher rate? Unknown.

Yamhill Community Care

Serves OHP (Medicaid) clients in: Yamhill, Polk (partial) and Washington counties

Who is the THW liaison? Contact Lily Sintim at lsintim@yamhillcco.org for questions about working with Yamhill Community Care.

Can individual THW birth doulas bill for their services, without a contract? Yes.

Does the CCO reimburse doulas more than the state’s FFS rate ($350 for 2 prenatal visits, labor support and 2 postpartum visits)? Not at this time, but maybe in the future. Contact the CCO for more information.

Last updated: Feb. 17, 2021

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