What PACIFICSOURCE COMMUNITY SOLUTIONS does

PacificSource Community Solutions operates as a Coordinated Care Organization (CCO) within Oregon's Medicaid program, managing Oregon Health Plan (OHP) benefits for low-income individuals, families, pregnant women, children, and people with disabilities in specific Oregon regions. Founded in 2016 and headquartered in Springfield, Oregon, the entity is part of the broader not-for-profit PacificSource family of health plans, alongside PacificSource Health Plans, PacificSource Community Health Plans, and PacificSource Administrators, Inc. The primary go-to-market is state-contracted CCO operations, with member acquisition occurring through Oregon Health Authority enrollment and assignment processes, supplemented by CMS Medicare enrollment, direct employer sales, a producer/broker network, and provider referrals.

The company's product portfolio spans Medicaid managed care (its core CCO offering), Medicare Advantage plans including HMO-DSNP dual eligible products, commercial individual and family plans, employer-sponsored plans (small group, large group, and self-funded), dental and vision plans, behavioral health services, and the Program of All-Inclusive Care for the Elderly (PACE). The underlying technology stack centers on the InTouch member portal and the myPacificSource mobile application, which provide members access to coverage information, benefits, claims, ID card printing, and communications preferences, alongside a 24-hour NurseLine, prior authorization systems, and a separate provider-facing InTouch portal for claims management, electronic HIPAA-compliant transactions, and clinical policy access. Telehealth services are offered as an integrated care delivery channel.

Revenue is generated primarily through capitated per-member-per-month payments from the Oregon Health Authority for Medicaid/OHP members, Medicare Part C capitation for Medicare Advantage plans, and premium revenue from commercial individual, family, and employer group plans. Pricing for Medicaid/OHP benefits is set by the Oregon Health Authority and not publicly disclosed by the company; commercial plan pricing varies by plan type, coverage level, and enrollment; Medicare Advantage pricing follows CMS guidelines. The company maintains an active digital marketing presence across Facebook, LinkedIn, Instagram, YouTube, and a corporate blog, with regional operations concentrated in Oregon and no global footprint claimed.

Name

PACIFICSOURCE COMMUNITY SOLUTIONS

Legal name

PacificSource Community Solutions

Website

https://communitysolutions.pacificsource.com

Company type

Private

Operating status

Operating

Headcount range

1–10 employees

Short description

PacificSource Community Solutions is a Coordinated Care Organization managing Oregon Medicaid (OHP) benefits for low-income Oregonians, and also offers Medicare Advantage, commercial, dental, vision, and PACE plans through the broader PacificSource not-for-profit health plan family.

Ownership category

akta.pro rank

Headquarters

HQ city

Springfield

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Medicaid/OHP Capitation: PacificSource Community Solutions operates as a Coordinated Care Organization (CCO) receiving capitated payments from the Oregon Health Authority to manage and coordinate healthcare benefits for Medicaid/OHP members in specific Oregon regions. Revenue is generated through fixed per-member-per-month payments based on enrolled member count and risk-adjusted demographics.
2. Medicare Advantage Plans: PacificSource offers Medicare Advantage plans including HMO-DSNP (Dual Eligible Special Needs Plans) for individuals eligible for both Medicare and Medicaid, generating revenue through Medicare Part C payments.
3. Commercial Health Plans: Individual, family, and employer-sponsored health insurance plans including small group, large group, and self-funded options. Revenue generated through premiums from individuals and employer groups.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels7 records

Core offering

PacificSource Community Solutions is a Coordinated Care Organization (CCO) that administers Oregon Health Plan (Medicaid) benefits for low-income Oregon residents in Central Oregon, Columbia Gorge, and Lane County regions. It also offers Medicare Advantage plans (including D-SNP for dual-eligible individuals), commercial individual/family and employer-sponsored group health plans, dental coverage, and the Program of All-Inclusive Care for the Elderly (PACE).

Product overview

PacificSource Community Solutions operates as a coordinated care organization and health insurance provider offering a multi-product portfolio. The core offerings include Medicaid/OHP plans administered through Oregon's coordinated care model, Medicare Advantage plans (including D-SNP dual plans), and commercial insurance for individuals, families, and employers. The ecosystem is anchored by the InTouch member portal (web and mobile app), which serves as the unified gateway for members to access benefits, claims, and plan management across all product lines. Supporting modules include dental, vision, behavioral health, and telehealth services integrated into the various plan types. Provider-facing tools include the InTouch Provider Portal for administrative functions. The company operates as a not-for-profit health plan organization with products provided through PacificSource Health Plans, PacificSource Community Solutions, PacificSource Community Health Plans, and PacificSource Administrators, Inc.

Differentiator

Problem solved

Functional benefit

Products and services

• Oregon Health Plan (Medicaid) CCO Coverage

Named customers1 record

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Molina Healthcare: Molina Healthcare is a national managed care company focused on Medicaid and Medicare programs, including government-sponsored insurance for low-income and dual-eligible populations. It is comparable to PacificSource Community Solutions in product mix and target populations, with similar capitation-driven economics.
• Providence Health Plan: Providence Health Plan offers commercial, Medicare Advantage, and Medicaid products in Oregon as part of the Providence health system. It overlaps with PacificSource Community Solutions in commercial and Medicare markets and participates in some CCO provider networks.
• Centene: Centene is the largest U.S. Medicaid managed care insurer and operates multiple state health plans nationwide. While not currently the primary CCO in Oregon's regions served by PacificSource Community Solutions, Centene is comparable as a Medicaid-focused MCO and represents a competitive threat if it pursues Oregon contracts.
• Kaiser Permanente Northwest: Kaiser Permanente Northwest operates an integrated health plan and care delivery system in Oregon and Washington, offering commercial, Medicare, and Medicaid products. It competes with PacificSource Community Solutions for Oregon employer, Medicare, and Medicaid members, but at much larger scale and with owned provider networks.

Direct peers

• Yamhill Community Care Organization: Yamhill Community Care Organization is an Oregon CCO serving Yamhill County and parts of Washington and Polk counties. It operates under the same CCO regulatory framework as PacificSource Community Solutions, providing coordinated Medicaid services.
• Health Share of Oregon: Health Share of Oregon is one of the largest CCOs in Oregon, serving Medicaid members in the Portland tri-county area. It shares the same CCO regulatory model, capitated Medicaid funding, and integrated care coordination mandate as PacificSource Community Solutions.
• CareOregon: CareOregon is a nonprofit Coordinated Care Organization serving Oregon Health Plan (Medicaid) members across multiple Oregon regions. Like PacificSource Community Solutions, it operates under CCO contracts with the Oregon Health Authority and coordinates integrated physical, behavioral, and dental care for low-income populations, making it the closest direct peer.
• AllCare Health: AllCare Health is a Coordinated Care Organization operating in southern Oregon (Jackson, Josephine, and Curry counties) that manages Oregon Health Plan benefits. It mirrors PacificSource Community Solutions' CCO model and target Medicaid population.
• Trillium Community Health Plan: Trillium Community Health Plan is an Oregon CCO serving Medicaid members in Lane, Clackamas, and Multnomah counties under contract with the Oregon Health Authority. It directly competes with PacificSource Community Solutions in overlapping Oregon regions.

Regional players

• Moda Health: Moda Health is an Oregon-based health insurer offering commercial, Medicare Advantage, and dental plans across the Pacific Northwest. It is comparable to PacificSource Community Solutions' commercial and Medicare product lines but operates primarily outside Oregon Medicaid.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat3 records

Key risks5 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/user/pacificsource
• Facebookfacebook.com/PacificSource
• LinkedInlinkedin.com/company/pacificsource-community-solutions
• Instagraminstagram.com/pacificsourcehealthplans

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

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

M&A

Investments

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

Frequently asked questions about PACIFICSOURCE COMMUNITY SOLUTIONS