Lessons From the Oregon Health Authority

This case study, published jointly by the Milbank Memorial Fund and Community Catalyst, takes a closer look at the role of Community Advisory Councils (CACs) in fostering meaningful engagement for Medicaid enrollees in Oregon’s Coordinated Care Organizations (CCOs).

The study is based on site visits and phone interviews with both patients and CCO staff members of CACs, and Oregon Health Authority (OHA) staff engaged in supporting and strengthening the state’s CACs.

Following the adoption of the Affordable Care Act, the Oregon legislature passed bipartisan enabling legislation establishing coordinated care organizations (CCO) — local networks of health care providers (including physical, mental health and addiction, and dental) that serve approximately 600,000 enrollees in the Oregon Health Plan, the state’s Medicaid program. The law required each CCO to create at least one community advisory council, an advisory body made up of OHP members and community representatives. CACs are responsible for overseeing a community health assessment and developing a community health improvement plan.

In 2012, OHA was awarded a four-year, $45 million State Innovation Model grant from the Centers for Medicare and Medicaid Services. This enabled the creation of a Transformation Center within OHA that has committed staffing and other resources to CAC development that have kept Oregon in the forefront among states making ongoing and serious investments in Medicaid consumer engagement. The nature of these investments and the successes and challenges of building a strong consumer engagement infrastructure are covered in the case study.

OHA’s approach to prioritizing and supporting meaningful consumer and community engagement through CACs offers several lessons for other state agencies, health plans and accountable care entities.

The “Best Practices” section of the case study covers these principles for successful engagement:

  • Prioritize engagement
  • Invest staff time and financial resources
  • Give beneficiaries meaningful work
  • Measure and communicate outcomes
  • Support an inclusive environment
  • Share “what works”


Deputy Director Renée Markus Hodin
Program and Policy Coordinator Madison Tallant