Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 50,000 | 362,543 | 1,526,389 | 1,676,151 | 1,144,558 | 4,759,641 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 568,153,396 | 584,644,518 | 558,281,700 | 832,133,142 | 918,922,129 | 3,462,134,885 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 568,203,396 | 585,007,061 | 559,808,089 | 833,809,293 | 920,066,687 | 3,466,894,526 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 3,466,894,526 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 568,203,396 | 585,007,061 | 559,808,089 | 833,809,293 | 920,066,687 | 3,466,894,526 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,069,125 | 4,221,135 | 4,037,837 | 4,841,109 | 6,384,386 | 23,553,592 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 4,069,125 | 4,221,135 | 4,037,837 | 4,841,109 | 6,384,386 | 23,553,592 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 5,740 | 0 | 5,740 | |||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 572,278,261 | 589,228,196 | 563,845,926 | 838,650,402 | 926,451,073 | 3,490,453,858 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| SUPPLEMENTAL INFORMATION TO 2015 FORM 990 FOR CAREOREGON, INC. | PART I, LINE 1 TAX-EXEMPT PURPOSE AND MISSION OF CAREOREGON CAREOREGON IS A NONPROFIT HEALTH PLAN ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES. IT HAS CONTRACTED WITH SEVERAL COORDINATED CARE ORGANIZATIONS (CCOS) AND WITH THE OREGON HEALTH AUTHORITY (OHA) TO MANAGE CARE AND PROVIDE HEALTHCARE SERVICES TO MEDICAID ENROLLEES. WE CULTIVATE INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH, REGARDLESS OF INCOME OR SOCIAL CIRCUMSTANCES, WITH A FOCUS NOT JUST ON HEALTH CARE, BUT ON TOTAL HEALTH THROUGH SHARED LEARNING AND INNOVATION. TEAMING WITH OUR CONTRACTED HEALTH PROVIDERS, OUR PLAN MEMBERS AND THEIR FAMILIES, AND THE COMMUNITIES WE SERVE, CAREOREGON HELPS INDIVIDUALS LIVE BETTER LIVES, PREVENT ILLNESSES AND RESPOND QUICKLY AND EFFECTIVELY TO HEALTH CHALLENGES. CAREOREGON PROVIDES CARE SUPPORT AND POPULATION HEALTH MANAGEMENT SERVICES TO MEMBERS WITH MEDICAID AND/OR MEDICARE. OUR CARE SUPPORT PROGRAM PROVIDES MULTIDISCIPLINARY, PERSON-CENTERED CASE MANAGEMENT SERVICES TO OUR AT-RISK MEMBERS. WE IDENTIFY AT-RISK MEMBERS PROACTIVELY USING A CLAIMS BASED PREDICTIVE MODEL, HEALTH RISK ASSESSMENT ON NEW MEMBERS, INTERNAL UTILIZATION MANAGEMENT, AND PHARMACY AND QUALITY PROCESSES. WE GO OUT INTO THE COMMUNITY TO MEET WITH HIGH-RISK PATIENTS TO REALLY UNDERSTAND THEIR BARRIERS TO HEALTH. WE CREATIVELY ADDRESS OTHER SOCIAL DETERMINANTS OF HEALTH BEYOND TRADITIONAL MEDICAL CARE. WE ARE WORKING TOWARDS BETTER COORDINATION OF MEDICAL,DENTAL AND MENTAL HEALTH SERVICES WITH INNOVATIVE PROGRAMS IN PRIMARY CARE. OUR STAFF WORKS IN TEAMS COMPRISED OF REGISTERED NURSES, BEHAVIORAL HEALTH SPECIALISTS, CLINICAL PHARMACISTS AND MEDICAL ASSISTANTS TO PROVIDE PATIENT-CENTERED INTERVENTIONS AND BETTER LINKAGE IN SUPPORT OF THE PRIMARY PROVIDERS CARE PLAN. ALSO, WE SUPPORT AND ENGAGE WITH HEALTH CARE PROVIDERS AND MEDICAID COORDINATED CARE ORGANIZATIONS ON QUALITY IMPROVEMENT PROGRAMS AND PRIMARY CARE REDESIGN AND IMPROVEMENT. WE CONTRACT WITH PUBLIC AND PRIVATE PROVIDERS AND WORK WITH THE LEGISLATURE AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE THE HEALTH AND WELL-BEING OF OREGONIANS. PART I, LINE 8-22 SUMMARY - REVENUE AND EXPENSES CAREOREGON EXPERIENCED AN APPROXIMATE $90 MILLION INCREASE IN TOTAL REVENUE AND AN APPROXIMATE $87 MILLION INCREASE IN EXPENSES IN 2015 COMPARED TO 2014. THE INCREASE IN REVENUE WAS PRIMARILY DUE TO A DECREASE IN MINIMUM MEDICAL LOSS RATIO REBATES AND AN INCREASE IN MEMBERSHIP AND CAPITATION RATES. THE INCREASE IN EXPENSES WAS MAINLY RELATED TO THE INCREASE IN HEALTHCARE COSTS AND ADMINISTRATIVE EXPENSES TO SERVE OUR MEMBERS. PART III, LINE 2 NEW PROGRAM SERVICES IN 2015, CAREOREGON BEGAN OFFERING A NUMBER OF PROGRAMS AND SERVICES. OHA BEGAN TRANSFERRING THE RISK AND ADMINISTRATION OF NON-EMERGENT MEDICAL TRANSPORTATION (NEMT) TO THE CCOS IN 2014. OUR JACKSON CARE CONNECT CCO AND COLUMBIA PACIFIC CCO BEGAN OFFERING NEMT BENEFITS IN OCTOBER 2014 AND JANUARY 2015, RESPECTIVELY. CLATSOP COUNTY IS ONE OF THE FIVE COMMUNITIES IN THE NATION SELECTED FOR A FIVE-YEAR HEALTH IMPROVEMENT PROGRAM CALLED WAY TO WELLVILLE. LED BY OUR COLUMBIA PACIFIC CCO AND OTHER PARTNERS, THE PROGRAM PRIORITIES FOR YEAR 2 ARE FOCUSING ON REDUCTION IN OBESITY AND IMPROVING ACCESS TO HEALTHY FOODS, PRENATAL EDUCATION AND CARE, AND BETTER ACCESS TO MENTAL HEALTH, SUBSTANCE ABUSE AND CHEMICAL DEPENDENCY SERVICES. CAREOREGON ALSO PROVIDED MORE THAN $100,000 IN COMMUNITY BENEFIT GRANTS TO NONPROFIT ORGANIZATIONS IN CLATSOP COUNTY THAT SUPPORT THOSE WHO ARE HOMELESS, HAVE FOOD INSECURITY OR ARE STRUGGLING WITH ADDICTIONS. WE ALSO COLLABORATE WITH PRIVATE AND PUBLIC AGENCIES TO CONNECT INDIVIDUALS FROM DIFFERENT CULTURES MORE EFFICIENTLY AND SEAMLESSLY TO THE CARE SERVICES THEY NEED. THESE COMMUNITY GRANTS SUPPORT CAREOREGONS HEALTH EQUITY OBJECTIVES. CAREOREGON IS THE NORTH AMERICAN PROVIDER OF ENGLANDS NATIONAL HEALTH SERVICE PROGRAMS, SUCH AS RELEASING TIME TO CARE. THE PROGRAM ENGAGES HOSPITALS IN IMPROVEMENT PROCESSES, ONE NURSING UNIT AT A TIME. LED BY TEAMS OF NURSING STAFF, IT USES LEAN TECHNIQUES TO HELP ELIMINATE INTERRUPTIONS AND OTHER INEFFICIENCIES, DELEGATE ROUTINE FUNCTIONS TO OTHER STAFF, AND STREAMLINE THE NURSES ENVIRONMENT AND WORK FLOWS. THE RESULTANT TIME SAVINGS ALLOW MORE FOCUS ON PATIENT-CENTERED NEEDS, WHICH RESULTS IN MEASURABLY BETTER, SAFER AND MORE RELIABLE CARE AS WELL AS A BETTER CARE EXPERIENCE FOR PATIENTS AND FAMILY MEMBERS. THE RT2C PROGRAM IS NOW INFLUENCING PROCESS IMPROVEMENTS THROUGHOUT THE HOSPITALS INVOLVED, AND HAS EXPANDED TO HOSPITALS IN MORE THAN A DOZEN STATES. CAREOREGON IS ALSO USING THE SAME LEAN TECHNIQUES TO OFFER A SIMILAR PROGRAM, CALLED THE PRODUCTIVE OPERATING THEATRE PROGRAM OR TPOT. IT USES THE SAME LEAN TECHNIQUES AS RT2C, AND THE INITIAL EFFORT HAS PROVEN SUCCESSFUL. OTHER HOSPITALS ARE SHOWING INTEREST IN THE PROGRAM AND WE HOPE TO EXPAND IT IN FUTURE YEARS. ADDITIONALLY, IN 2015 WE BEGAN PILOT TESTING OF THE RT2C LEAN TECHNIQUES TO THE NURSING STAFF AT LONG-TERM CARE FACILITIES, AS A PROGRAM CALLED CAREHOMES WELL-BEING. CAREOREGON APPLIED FOR GRANT FUNDING FOR THE PROGRAM, WHICH WAS RECEIVED IN EARLY 2016. A NUMBER OF NEW PILOT PROGRAMS IMPLEMENTED IN 2015 INCLUDE MAKING CHANGE, CAREOREGON GOMOBILE, AND THE SAFELINK FREE PHONE PROGRAM. 1) MAKING CHANGE OFFERS INTENSIVE COACHING TO SELECTED MEMBERS TO HELP THEM BETTER UNDERSTAND PERSONAL FINANCE, SUCH AS HOW TO MANAGE THEIR MONEY, FIND BETTER PAYING JOBS, STRETCH THEIR AVAILABLE DOLLARS, AND CREATE MICROWORK PROJECTS TO EARN SOME IMMEDIATE INCOME UNTIL THEY CAN LAND PERMANENT JOBS. A GOAL IS TO HELP MEMBERS REDUCE THE STRESS CAUSED BY FINANCES AND TAKE THE FIRST STEP TOWARD FINANCIAL STABILITY. 2) CAREOREGON GOMOBILE OHP NAVIGATION CLINICS HELP WITH MEDICAID MENTAL, DENTAL AND MENTAL HEALTH APPOINTMENTS, AND ESTABLISH MEDICARE ELIGIBILITY FOR DISABLED AND ELDERLY ADULTS. EACH MONTH, ABOUT 11 CLINICS ARE HELD AT FIVE LOCATIONS IN PORTLAND METRO AREA HOMELESS SHELTERS AND NONPROFIT PARTNER SOCIAL SERVICE AGENCIES SERVING THOSE WHO ARE LOW-INCOME OR HOMELESS. 3) THE SAFELINK FREE PHONE PROGRAM ALLOWS MEMBERS TO REACH CAREOREGON CUSTOMER SERVICE, AS WELL AS HEALTH PROVIDERS, IN ORDER TO MORE EASILY ACCESS AND COORDINATE THEIR CARE. THEY ALSO CAN RECEIVE HEALTH RELATED TEXTS. THE POPULATION HEALTH PARTNERSHIPS DEPARTMENT WAS CREATED IN LATE 2014 TO REORGANIZE CARE MANAGEMENT PROGRAMS THAT SERVE THE HIGHEST RISK MEMBERS TO BE MORE COMMUNITY FACING. CLINICAL STAFF HAVE BEEN PLACED AT LOCAL CLINICS TO IMPROVE CARE IN THE AREAS OF BEHAVIORAL HEALTH, ADVANCED ILLNESS AND HOUSING. THE PROGRAMS INCLUDE: 1) HEALTH RESILIENCE PROGRAM COMMUNITY HEALTH WORKERS HELP MEMBERS BETTER MEET THEIR OWN NEEDS BY WALKING ALONGSIDE THEM AND SHOWING THEM HOW TO IMPROVE THEIR LIVES AND REACH THEIR HEALTH GOALS. 2) EXCEPTIONAL NEEDS CARE COORDINATION PROGRAM CAREOREGON INVESTED IN THE EXCEPTIONAL NEEDS MEDICAL AND DENTAL SERVICES. IT IS A PARTNERSHIP BETWEEN PROVIDERS AND MEMBERS WITH CHRONIC AND DEBILITATING ILLNESSES AND CONDITIONS, INCLUDING THOSE WHO HAVE PHYSICAL DISABILITIES OR OTHERWISE REQUIRE ASSISTANCE WITH THEIR ACTIVITIES OF DAILY LIVING AND ARE UNABLE TO OBTAIN TREATMENT IN A TRADITIONAL OFFICE SETTING. 3) ADVANCED ILLNESS CARE THIS PROGRAM PARTNERS WITH LOCAL HOSPICES TO PROVIDE OUTPATIENT PALLIATIVE CARE FOR UNDERSERVED POPULATIONS FACING END-OF-LIFE ILLNESSES. A PRIMARY CARE MODEL WAS DEVELOPED TO MENTOR PROVIDERS AND EXPAND ACCESS TO THIS CARE WITHIN SAFETY NET PRACTICES. 4) SPOTLIGHT INITIATIVE AT THE END OF 2015, CAREOREGON BEGAN DEVELOPING A PROGRAM TO HELP REDUCE AVOIDABLE HOSPITALIZATIONS AND EMERGENCY ROOM USE OF DUALLY-ELIGIBLE MEDICAID AND MEDICARE MEMBERS. CAREOREGON AND COMMUNITY PARTNERS WILL BE PROVIDING INDIVIDUALIZED WRAP AROUND SERVICES TO MEMBERS TO HELP ADDRESS THE MEMBERS PHYSICAL HEALTH, BEHAVIORAL HEALTH AND OTHER NEEDS. 5) COMMUNITY HEALTH PROGRAMS THE COMMUNITY HEALTH TEAM DESIGNS AND IMPLEMENTS INDIVIDUAL AND COMMUNITY-WIDE SERVICES TO INCREASE FOOD SECURITY, IMPROVE NUTRITION, SUPPORT SOCIALIZATION AND ENHANCE HOUSING STABILITY. THESE ARE SOME OF THE MOST IMPORTANT DETERMINANTS OF GOOD HEALTH AND WELL-BEING. |
| SUPPLEMENTAL INFORMATION TO 2015 FORM 990 FOR CAREOREGON, INC. (CONT'D) | PART III, LINE 4 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS A. OREGON HEALTH PLAN (MEDICAID) PROGRAM THROUGH THE CCOS, CAREOREGON PROVIDES HEALTH CARE SERVICES TO OVER 250,000 MEDICAID MEMBERS BY CONTRACTING WITH NETWORKS OF COMMUNITY AND PRIVATE MEDICAL PROVIDERS THROUGHOUT THE STATE OF OREGON. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. B. MEDICARE PLAN ON BEHALF OF HEALTH PLAN OF CAREOREGON, PARENT CAREOREGON ADMINISTERS CAREOREGON ADVANTAGE PLUS MEDICARE SPECIAL NEEDS PLAN (SNP). SNP PROVIDES CONTINUITY OF COVERAGE FOR MEMBERS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. THE CONTINUITY BENEFITS BOTH PATIENTS AND PROVIDERS BY ENSURING A COORDINATED AND CONVENIENT MEANS OF RECEIVING AND DELIVERING QUALITY CARE. WE ALSO ADMINISTER CAREOREGON ADVANTAGE STAR, A LOW COST MEDICARE ADVANTAGE PLAN. OUR MEDICARE PLANS SERVED APPROXIMATELY 13,000 MEMBERS IN 2015. C. CHARITABLE CONTRIBUTIONS WITH CAREOREGONS GOAL OF CONTINUOUSLY INVESTING IN THE COMMUNITIES WE SERVE, WE CONTRIBUTED MORE THAN $2.2 MILLION IN 2015 TO OTHER NONPROFIT CHARITABLE ORGANIZATIONS THAT STRIVE TO IMPROVE HEALTH CARE IN OREGON AND TO IMPROVE HEALTH CARE STATUS OF VULNERABLE AND UNDERSERVED POPULATIONS. D. OTHER PROGRAM SERVICES THE CCOS WE SUPPORT PROVIDE ACCESS FOR OVER 250,000 LOW-INCOME OREGONIANS. OUR WORK INVOLVES COORDINATING QUALITY HEALTH CARE FOR MEMBERS AND CONTRACTING WITH PUBLIC AND PRIVATE PROVIDERS TO PROVIDE HEALTH CARE SERVICES. WE PROVIDE CUSTOMER SERVICE FUNCTIONS FOR THESE CCOS, ASSIST WITH HEALTH IMPROVEMENT PLANS FOR THE VARIOUS COMMUNITIES AND PROVIDE TECHNICAL SUPPORT FOR INFORMATION SERVICES, COMMUNICATIONS, PROCESS IMPROVEMENT AND OTHER FUNCTIONS. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. IN 2015 WE CONTINUED TO PROVIDE COMMUNITY OUTREACH, SUPPORT AND CARE COORDINATION SERVICES TO HIGH-RISK MEMBERS IN MULTNOMAH, WASHINGTON AND CLACKAMAS COUNTIES UNDER A CENTER FOR MEDICARE AND MEDICAID INNOVATIONS (CMMI) GRANT. THE CMMI GRANT, A THREE-YEAR AWARD THAT ENDED JUNE 30, 2015, AIMED AT DEVELOPING NEW INTEGRATED MODELS OF CARE TO IMPROVE HEALTH OUTCOMES AND REDUCE COSTS FOR THE ADULT MEDICAID POPULATION. WE ENCOURAGE CLINICS TO PROVIDE THE BEST PRIMARY CARE POSSIBLE THROUGH OUR VARIOUS IMPROVEMENT AND INCENTIVE-PAYMENT PROGRAMS TO BUILD SYSTEMS AND PROCESSES FOR PROACTIVE PANEL MANAGEMENT, TEAM-BASED CARE, NURSE-LED CASE MANAGEMENT, PATIENT EMPOWERMENT FOR SELF-MANAGEMENT, INTEGRATION OF PHYSICAL AND MENTAL HEALTH CARE, IMMUNIZATION AND DISEASE-SPECIFIC PATIENT REGISTRIES, AND SAME-DAY AND EXTENDED-HOUR MEMBER ACCESS TO THE CARE TEAM. ALL OF THESE IMPROVEMENTS ARE DONE WITH THE GOAL OF COST-EFFECTIVE, CONTINUOUS, AND COORDINATED CARE. OUR MODEL IS ONE OF LEARNING FOR THE MEMBER; ACTING FOR THE POPULATION. WE PARTICIPATE ACTIVELY IN THE INSTITUTE OF HEALTHCARE IMPROVEMENTS TRIPLE AIM, A NATIONWIDE INITIATIVE THAT LOOKS AT MAXIMIZING RESULTS IN THREE AREAS: OUTCOME EXCELLENCE, PATIENT SATISFACTION AND COST EFFECTIVENESS. WE CONTINUED TO WORK WITH CLINICS TO IMPROVE THE PATIENT-CENTERED PRIMARY CARE MEDICAL HOME MODEL AT OUR CONTRACTED CLINICS. WE HAVE EXPANDED THE COLLABORATIVE TO CLINICS (PATIENT AND POPULATION CENTERED PRIMARY CARE) IN MORE RURAL SETTINGS, TO HELP THEM TRANSFORM THEIR PROCESSES, DATA SYSTEMS, AND WORKFORCE TO IMPROVE PATIENT EXPERIENCE AND CLINICAL OUTCOMES. TO FULFILL CAREOREGONS MISSION OF CULTIVATING INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH THROUGH SHARED LEARNING AND INNOVATION, CAREOREGON EXPANDED PROJECTS PILOTED IN 2013, INCLUDING FOOD RX, GIVE2GET, MEDSTM (MY EASY DRUG SYSTEM), PREGNANT AND NEW MOM SUPPORT, AND HEALTH TRANSPORTATION SERVICES: 1) UNDER THE FOOD RX PROGRAM, CAREOREGON PARTNERS WITH CLINICS AND LOCAL FOOD PURVEYORS TO PROVIDE UNDERSERVED OREGONIANS WITH ACCESS TO FRESH, HEALTHY FOOD. THE GOAL IS TO ACHIEVE LONG-TERM BEHAVIOR CHANGE BY PROVIDING SHORT-TERM ACCESS TO HEALTHY FOOD, EDUCATION AND WELLNESS CLASSES. 2) GIVE2GET IS A PEER-TO-PEER NETWORKING PROGRAM THAT SEEKS TO IMPROVE MEMBER HEALTH BY SOLVING THE PROBLEM OF SOCIAL ISOLATION. MEMBERS ARE CONNECTED TO MEMBERS TO PROVIDE SERVICES TO EACH OTHER. IT GIVES HELP WHILE BUILDING A LARGER SENSE OF COMMUNITY. 3) MEDS IS A PROGRAM THAT HELPS MEMBERS UNDERSTAND THEIR MEDICATIONS SO THEY CAN TAKE THE MEDICATIONS CORRECTLY AT HOME. MEDS FACILITATES MEMBERS' CONVERSATIONS WITH DOCTORS AND PHARMACISTS ABOUT UNMET MEDICATION NEEDS. 4) THE STARTING STRONG PROGRAM OF JACKSON CARE CONNECT, AND THE FIRST STEPS PROGRAM OF COLUMBIA PACIFIC CCO, OFFER INCENTIVES TO PREGNANT WOMEN, NEW MOMS AND BABIES IN OUR JACKSON CARE CONNECT CCO (COORDINATED CARE ORGANIZATION) FOR TAKING HEALTHY ACTIONS. EXAMPLES OF HEALTHY ACTIONS ARE ATTENDING PRENATAL AND DENTAL APPOINTMENTS, BRINGING BABIES TO WELL-CHILD CHECK-UPS, ATTENDING CHILDBIRTH PREPARATION, PARENTING, NUTRITION AND DIABETES MANAGEMENT CLASSES. INCENTIVES INCLUDE HIGH CHAIRS, INFANT CAR SEATS AND BABY SUPPLIES. 5) NON-EMERGENCY MEDICAL TRANSPORTATION PROGRAMS AT ALL CCOS GREATLY EXPANDED IN 2015, MAKING IT EASIER FOR MEMBERS TO GET A FREE RIDE TO ANY TYPE OF HEALTH APPOINTMENT, BOTH IN THEIR AREA AND OUT OF TOWN IF NEEDING A SPECIALIST IN ANOTHER CITY. |
| SUPPLEMENTAL INFORMATION TO 2015 FORM 990 FOR CAREOREGON, INC. (CONT'D) | PART IV, LINE 12/12A CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2015, AN AUDIT WAS PERFORMED ON THE CONSOLIDATED ENTITY WHICH INCLUDES CAREOREGON, HEALTH PLAN OF CAREOREGON, CARE ACCESS, COLUMBIA PACIFIC CCO, JACKSON CARE CONNECT, AND LEAN HEALTHCARE WEST. PART VI, LINE 2 FAMILY AND BUSINESS RELATIONSHIP MARGARET S. ROWLAND, MD, CHIEF MEDICAL OFFICER OF CAREOREGON, INC., SERVES AS A MEMBER OF THE BOARD OF DIRECTORS OF ALBERTINA KERR. CHRIS KRENK, CHIEF EXECUTIVE OFFICER OF ALBERTINA KERR, SERVES ON CAREOREGONS BOARD OF DIRECTORS. PART VI, LINE 11A FORM 990 TO GOVERNING BODY CAREOREGONS FORM 990 IS REVIEWED BY THE CFO, FINANCE COMMITTEE AND BOARD OF DIRECTORS BEFORE IT IS FILED. THE FORM 990 IS DISCUSSED IN DETAIL AT THE FINANCE COMMITTEE MEETING PRIOR TO FILING. ALL REVIEWERS ARE GIVEN TIME TO RESPOND WITH ANY REVISIONS. AFTER INCORPORATION OF ALL REVISIONS, THE FORM 990 IS REDISTRIBUTED TO THE REVIEWERS PRIOR TO FILING. PART VI, LINE 12C ENFORCEMENT OF CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST POLICY OF CAREOREGON IS DISTRIBUTED TO THE BOARD MEMBERS ANNUALLY. IT APPLIES TO DIRECTORS, OFFICERS AND KEY EMPLOYEES (ON THE BASIS OF TESTS SET FORTH IN IRS FORM 990), AND ANY OTHER INDIVIDUAL IN A POSITION TO EXERCISE SIGNIFICANT INFLUENCE OVER A DECISION HAVING MATERIAL ECONOMIC IMPACT FOR CAREOREGON (COLLECTIVELY COVERED PERSONS). THE CONFLICT OF INTEREST POLICY IS REVIEWED AND APPROVED AT AN ANNUAL BOARD MEETING. AN ANNUAL CONFLICT OF INTEREST DECLARATION AND INDEPENDENCE QUESTIONNAIRE IS DISTRIBUTED TO ALL COVERED PERSONS. THROUGH THE DISTRIBUTED DOCUMENT, EACH COVERED PERSON SIGNS AND ACKNOWLEDGES THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY AND REPORTS FAMILY AND BUSINESS RELATIONSHIPS THAT ARE USED TO DETERMINE THE INDEPENDENCE OF A DIRECTOR PURSUANT TO THE DEFINITION AND TESTS SET FORTH IN IRS FORM 990. THE GOVERNANCE COMMITTEE REVIEWS THE RESPONSES TO THE ANNUAL QUESTIONNAIRES AND MAKES RECOMMENDATIONS TO THE FULL BOARD ON ANY RESOLUTIONS OR ACTIONS REQUIRED TO MITIGATE ANY CONFLICTS OF INTEREST. AT THE BEGINNING OF EACH MEETING OF THE BOARD OF DIRECTORS, THE CHAIR ASKS ALL MEMBERS PRESENT TO DECLARE ANY CONFLICTS OF INTEREST SO THE BOARD IS UPDATED ON ANY NEW CONFLICTS THAT MAY HAVE ARISEN SINCE THE LAST ANNUAL QUESTIONNAIRE. ALL SIGNED CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENTS AND INDEPENDENCE QUESTIONNAIRES ARE RETAINED AT CAREOREGONS OFFICE. IF A CONFLICT OF INTEREST EXISTS, AS DETERMINED BY THE BOARD, AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE MEETING, DISCLOSING THE EXISTENCE OF HIS OR HER INTEREST AND SHALL DISCLOSE ALL MATERIAL FACTS. FOLLOWING THE PERSONS DISCLOSURES AND AFTER ANY DISCUSSION WITH THE BOARD, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD INDEPENDENTLY DISCUSSES THE MATTER BEFORE IT AND VOTES ON THE PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. IF THERE IS REASONABLE QUESTION ABOUT THE APPROPRIATENESS OF THE PROPOSED TRANSACTION OR ARRANGEMENT, THE CHAIR SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTIONS OR ARRANGEMENTS. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL EVALUATE THE RESULTING ALTERNATIVES PRESENTED BY THE APPOINTED PERSON OR COMMITTEE. IF AN APPROPRIATE CONFLICT-FREE ALTERNATIVE IS NOT REASONABLY ATTAINABLE, THE BOARD SHALL DETERMINE BY MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN CAREOREGONS BEST INTEREST, FOR CAREOREGONS OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CAREOREGON, WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS AND THE BOARD THEN SHALL VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. PART VI, LINE 15A AND 15B PROCESS OF DETERMINING COMPENSATION MARKET DATA ON THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVE POSITIONS (CEO, COO, CFO, CMO, AND CNO) IS PROVIDED ANNUALLY BY AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT USING COMPARABLE ORGANIZATIONS BY INDUSTRY, PROFIT/NON-PROFIT STATUS AND REVENUE SIZE. THE COMPENSATION COMMITTEE, CONSISTING OF A MAJORITY OF INDEPENDENT BOARD MEMBERS, REVIEWS MARKET DATA, EVALUATES CEO PERFORMANCE AND REVIEWS CEO RECOMMENDATIONS FOR COMPENSATION FOR OTHER EXECUTIVE OFFICERS. THE COMMITTEE PRESENTS ITS RECOMMENDATIONS FOR CEO TO THE BOARD. DECISIONS ARE MADE IN A BOARD MEETING. THE BOARD REVIEWS THE RECOMMENDATION FOR THE COMPENSATION OF ALL OTHER EMPLOYEES AS PART OF THE BUDGET APPROVAL PROCESS. THE PROCESS OF DETERMINING THE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY OFFICERS INCLUDES A REVIEW OF AN INDEPENDENT CONSULTANTS REPORT OF COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS AND IS GUIDED BY WRITTEN COMPENSATION PRACTICES. WITH THE CEO AND ALL OTHER OFFICERS ABSENT FROM THE MEETINGS, THE BOARD APPROVES THE SALARY OF THE CEO. THIS PROCESS WAS LAST UNDERTAKEN ON FEBRUARY 2, 2015 FOR THE CEO, AND MARCH 21, 2016 FOR THE CEOS RECOMMENDATIONS FOR OTHER OFFICERS. PART VI, LINE 18 AND 19 PUBLIC INSPECTION THE TAX RETURN INFORMATION IS AVAILABLE UPON REQUEST. WHILE NO REQUIREMENT TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXISTS, CAREOREGON WILL CONSIDER ALL REQUESTS FOR THESE DOCUMENTS ON A CASE-BY-CASE BASIS. |
| PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES PARTNERSHIP INCOME FROM K-1 REPORTED FOR TAX, NOT INCLUDED IN BOOKS $ (29,673) TRANSFER FROM CAREOREGON $25,000,000 ----------- TOTAL $24,970,327 IN 2015, CAREOREGON TRANSFERRED $25,000,000 TO HEALTH PLAN OF CAREOREGON (HPCO), ITS WHOLLY-OWNED SUBSIDIARY, TO MEET RISK BASED CAPITAL (RBC) REQUIREMENTS. |
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