CareOregon

What CareOregon does

CareOregon is a nonprofit health plan founded in 1994 and headquartered in Portland, Oregon. Operating as a Coordinated Care Organization (CCO), it administers Oregon Health Plan (Medicaid) coverage for more than 500,000 members, making it the largest Medicaid health plan in Oregon. The organization also offers CareOregon Advantage, a Medicare Advantage HMO D-SNP for dual-eligible individuals, and operates the wholly-owned subsidiaries Columbia Pacific CCO, Jackson Care Connect, and Housecall Providers, along with its partnership in Health Share of Oregon.

CareOregon's product portfolio includes integrated physical, mental, dental, and vision health coverage delivered through an extensive provider network, plus non-clinical support services such as the Ride to Care transportation benefit, in-home palliative care through Housecall Providers, tribal care coordination with all nine Oregon federally recognized tribes, and the MyCareOregon mobile app for member self-service. The organization also runs a substantial community giving program that has deployed more than $85 million since 2020 to community-based organizations addressing social determinants of health, including $21.5 million committed to the Housing is Health initiative covering 379 low-income housing units and $2 million to integrate dental care across five safety-net clinics.

Revenue is generated primarily through capitated per-member-per-month payments from the Oregon Health Authority (Medicaid) and from CMS (Medicare Advantage). CareOregon distributes services via state-determined Medicaid enrollment, Medicare enrollment, community partner referrals, and self-serve digital channels, with go-to-market centered on community-led outreach through its Connect to Care team and member engagement via the member portal and MyCareOregon mobile app.

Name

CareOregon

Legal name

CareOregon, Inc.

Website

https://careoregon.org

Company type

Private

Founded year

1993

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

CareOregon is a Portland-based nonprofit health plan operating as Oregon's largest Medicaid Coordinated Care Organization, serving over 500,000 Oregon Health Plan members and dual-eligible Medicare Advantage enrollees through integrated care delivery and a social-determinants-of-health platform.

Ownership category

akta.pro rank

Product category

Medicaid Managed Care

NAICS

HMO Medical Centers (621491), Individual and Family Services (6241)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicaid Managed Care HMOs (HLAEAMAI)

akta.pro secondary industries

Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI), Medicare Advantage HMOs (HMO/HMO-POS) (HLAEAMAH), Care Management & Population Health Program Administration (HLAEALAG)

Keywords

• Medicaid managed care
• Medicare Advantage plans
• Coordinated Care Organization
• Care coordination services
• Community health plan

Headquarters

HQ city

Portland

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Oregon Health Plan (Medicaid) CCO: CareOregon operates as a Coordinated Care Organization (CCO) receiving capitated payments from the Oregon Health Authority to manage healthcare for Medicaid members. Revenue is generated through fixed per-member-per-month payments.
2. CareOregon Advantage Medicare: Medicare Advantage plan (HMO D-SNP) for individuals eligible for both Medicare and Medicaid, generating revenue through Medicare Advantage capitated payments.
3. Community Giving Program: Philanthropic grants and sponsorships to community organizations addressing social determinants of health. While this represents outflow rather than revenue, it demonstrates the organization's community investment model.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels7 records

Core offering

CareOregon is a nonprofit Coordinated Care Organization (CCO) that administers Oregon Health Plan (Medicaid) coverage to more than 500,000 low-income Oregonians under capitated contracts with the Oregon Health Authority. It also offers CareOregon Advantage, a Medicare Advantage HMO D-SNP plan for dual-eligible members, supported by integrated care coordination, in-home primary care (Housecall Providers), transportation (Ride to Care), tribal care coordination, and a community giving program investing over $85 million since 2020 in social determinants of health.

Product overview

CareOregon is an integrated health plan and coordinated care organization that operates as a multi-product portfolio. The core offering is the Oregon Health Plan (Medicaid) health plan serving over 500,000 members, supplemented by CareOregon Advantage (Medicare Advantage D-SNP) for dual-eligible members. The organization provides care through sub-brands including Housecall Providers (in-home primary care and palliative care), Columbia Pacific CCO, and Jackson Care Connect. Member-facing digital products include the MyCareOregon mobile app and member portal. Support services include Ride to Care (transportation), Connect to Care (community outreach), and Care Coordination Services. The CareOregon Community Giving Program provides grants to community organizations addressing social determinants of health.

Differentiator

Problem solved

Functional benefit

Products and services

• Oregon Health Plan (Medicaid) Coordinated Care
• CareOregon Advantage
• MyCareOregon Mobile App
• Ride to Care
• Housecall Providers
• Columbia Pacific CCO
• Jackson Care Connect
• Tribal Care Coordination
• Connect to Care
• CareOregon Community Giving Program

Quantifiable outcome

• Over 500,000 Oregon Health Plan members served - more than any other health plan
• +3 more outcomes

Named customers5 records

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Ten partnerships are on record, tiered core and minor.

• Oregon Health Authority (OHA)coreStrategic or Co-development Partner · 1 June 2018OHA partnered with CareOregon to develop a culturally appropriate, statewide care coordination program for American Indian/Alaska Native OHP members on fee-for-service, in coordination with all nine federally recognized tribes in Oregon and NARA.
• Housing is Health Coalition (Adventist Health Portland, Kaiser Permanente Northwest, Legacy Health, OHSU, Providence Health & Services Oregon)coreStrategic or Co-development Partner · 3 August 2017Six health organizations including CareOregon committed $21.5 million toward construction of three low-income housing projects totaling 379 units in East and North Portland. This pioneering partnership addresses housing as a social determinant of health.
• Native American Rehabilitation Association of the Northwest (NARA)coreStrategic or Co-development PartnerNARA is the tribal care coordination partner working with CareOregon and OHA to provide culturally responsive care coordination services for tribal members.
• Central City ConcerncoreStrategic or Co-development PartnerNonprofit serving people impacted by homelessness and poverty. Partner in Housing is Health initiative, developing affordable and supportive housing units with CareOregon funding and support.
• Virginia Garcia Memorial Health CenterminorStrategic or Co-development PartnerSafety-net clinic receiving CareOregon investment to integrate dental care with primary care services as part of oral health integration initiative.
• Health Share of OregoncoreStrategic or Co-development PartnerCareOregon is part of Health Share of Oregon, a coordinated care organization serving OHP members in the Portland metro area.
• Housecall ProviderscoreStrategic or Co-development PartnerPart of the CareOregon family, providing in-home primary care and palliative care services for members with chronic conditions and advanced illness.
• Columbia Pacific CCOcoreStrategic or Co-development PartnerPart of the CareOregon family, serving as a Coordinated Care Organization for OHP members in the Columbia Pacific region.
• Jackson Care ConnectcoreStrategic or Co-development PartnerPart of the CareOregon family, serving as a Coordinated Care Organization for OHP members in Jackson County.
• Oregon Health and Education CollaborativeminorStrategic or Co-development PartnerCareOregon supports recruitment for this collaborative, extending workforce development partnerships.

Scale indicators6 records

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• Humana: Humana is the largest U.S. Medicare Advantage operator with a major D-SNP franchise. It is comparable to CareOregon as a dual-eligible D-SNP competitor with strong capabilities serving complex, low-income Medicare populations.
• Molina Healthcare: Molina Healthcare is a large national Medicaid managed care organization with government-sponsored health plans across multiple states. It is comparable to CareOregon as a Medicaid-focused health plan serving low-income populations, though at much greater geographic scale.
• Centene Corporation: Centene is the largest U.S. Medicaid managed care operator with a national footprint including D-SNP and marketplace plans. Centene competes broadly with CareOregon in the Medicaid and dual-eligible segments, although it does not currently hold the Oregon CCO contracts that CareOregon dominates.
• Anthem (Elevance Health): Anthem/Elevance operates Medicaid, Medicare Advantage (including D-SNP), and commercial plans across most U.S. states via brands including Amerigroup and Anthem Blue Cross. Comparable to CareOregon as a diversified government-program health insurer with dual-eligible capabilities.

Direct peers

• PacificSource: PacificSource operates Coordinated Care Organizations (CCOs) in Oregon and a health plan across the Pacific Northwest. It is directly comparable to CareOregon as a regional nonprofit/regional health insurer serving Medicaid members in Oregon and adjacent states.
• Kaiser Permanente Northwest: Kaiser Permanente Northwest is an integrated health system and health plan serving Oregon and Southwest Washington, including Medicaid and Medicare Advantage members. It is highly comparable to CareOregon as both an Oregon-based CCO/Medicaid contractor and integrated payer-provider, and was even a co-investor in CareOregon's Housing is Health initiative.
• Trillium Community Health Plan: Trillium is an Oregon Coordinated Care Organization serving OHP members in Lane County and surrounding areas. It is a direct CCO peer to CareOregon under the same Oregon Medicaid CCO contracting framework.
• Health Share of Oregon: Health Share of Oregon is the largest Coordinated Care Organization in the Portland metro area. CareOregon is itself part of Health Share, making it a closely intertwined peer that shares the same Medicaid contract and member population.

Regional players

• Providence Health Plan: Providence Health Plan operates commercial, Medicaid, and Medicare Advantage plans across Oregon and the Pacific Northwest. It is comparable to CareOregon as a regional nonprofit health plan and was a co-investor in the Housing is Health initiative, signaling peer positioning in Oregon's coordinated care ecosystem.
• Regence BlueCross BlueShield of Oregon: Regence BlueCross BlueShield of Oregon is a regional nonprofit health plan serving commercial, Medicare, and Medicaid members across Oregon. It is comparable to CareOregon as a Pacific Northwest nonprofit plan with government program exposure.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks4 records

Key highlights6 records

Customer concentration

• Xx.com/CareOregon
• YouTubeyoutube.com/@CareOregon
• Facebookfacebook.com/CareOregon
• LinkedInlinkedin.com/company/careoregon
• Instagraminstagram.com/careoregon

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments1 record

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about CareOregon