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February 10, 2023
Media Contact: Amy Bacher, 503-405-5403, amy.bacher2@oha.oregon.gov
The agency will coordinate with other state entities to conduct further analysis and seek additional public comment
Portland, Ore. – Today the Oregon Health Authority (OHA) announced it will conduct a comprehensive review of the proposed transaction between SCAN Group and CareOregon. By law, the agency is tasked with reviewing business deals involving health care entities to promote transparency, monitor the impact of health care consolidation, and ensure that health care transactions in Oregon support statewide goals related to health equity, lower costs, increased access, and better quality of care. A report is publicly available online and explains next steps, which includes an extended public comment period.
On January 12, OHA accepted a notice of material change transaction from SCAN Group and CareOregon that describes plans for the companies to combine. SCAN Group is a California-based non-profit company that offers Medicare Advantage plans and health care services, focusing on care for older adults. CareOregon provides benefits to more than 500,000 members of three coordinated care organizations (CCOs) in Oregon, serving seven counties: Columbia Pacific CCO, Health Share of Oregon, and Jackson Care Connect. Under the proposed transaction, SCAN Group will be renamed HealthRight and become the parent company of CareOregon. CareOregon will contribute up to $70 million over multiple years to affiliate with HealthRight.
OHA is conducting the comprehensive review via the Health Care Market Oversight (HCMO) program. The Oregon legislature established HCMO via HB2362 in 2021 and the program launched in March 2022. HCMO reviews proposed business deals involving health care entities, such as hospitals, health insurance companies, and provider groups to assess the impact of these deals on healthcare costs and access to high quality care, particularly for communities that experience inequities.
This transaction is subject to multiple regulatory reviews. The comprehensive review will collect additional information about the transaction, encourage public comment, and examine the potential impacts on cost, quality, access, and equity for people in Oregon. Simultaneously, the Oregon Department of Consumer and Business Services (DCBS) and OHA’s Medicaid Finance Team will conduct a domestic insurer Form A review of the transaction, which will examine the transaction’s alignment with legal requirements, financial condition, leadership, control, and competition. The CCO Form A review will assess the transaction’s alignment with CCO requirements and impact on OHP members. DCBS and OHA will hold public hearings as part of the Form A reviews later this year.
The comprehensive review will be completed within 180 days, unless extended in accordance with applicable law. Upon completion of the comprehensive review, HCMO will make a recommendation to DCBS, rather than issuing a standalone decision. DCBS and OHA will each make a final determination about the transaction once both Form A reviews are completed, and the HCMO recommendation is considered. If both DCBS and OHA approve, the transaction may proceed as proposed.
OHA will accept and post public comments throughout the comprehensive review period. Public input is crucial to help OHA understand potential impacts on the cost of health care, quality, access to services, and health equity. Comments can be submitted via email to hcmo.info@oha.oregon.gov.
The preliminary review report, along with additional documents related to the transaction, can be located here.
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