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Read about: an important message for providers

About the program

Health-related services (HRS) are non-covered services under Oregon’s Medicaid plan that are not administrative requirements and are intended to improve care delivery and overall member and community health and well-being. One of the purposes of HRS is to allow coordinated care organizations (CCOs) an opportunity to address the social determinants of health and equity (SDOH-E), including the health-related social needs, of their members. For CCOs to use Oregon’s Medicaid funds to pay for HRS, they must comply with state and federal criteria. 

Funding options

There are two ways CCOs can provide health-related services (find out more by clicking the link to each funding option): 

  • Flexible services (flex requests): Cost-effective non-billable services delivered to an individual OHP member to supplement covered benefits and improve their health and well-being.  
  • Community benefit initiatives (CBI): CareOregon facilitated community-level partnerships that include — but are not limited to — OHP members and are focused on improving population health and health care quality. 

Additional resources

For more resources about HRS, please go to the HRS section on the Oregon Health Authority (OHA) website. It should have the most up-to-date information, including more information on using
HRS to address SDOH-E. 

 A few helpful resources we like from the page include: 

Questions? Email us at social.determinants@careoregon.org

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