Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Oregon’s Medicaid program is known as Oregon Health Plan.
Enrollment
More than 78,000 Kaiser Permanente members are enrolled in Oregon Health Plan. 31% are children, 64% are adults, and 5% are seniors.
Participation
Kaiser Permanente participates in 6 counties in Oregon, mainly concentrated in the Portland metro area. To provide care and coverage in Oregon, Kaiser Permanente is a founding member of Health Share of Oregon in the Portland metro area. We also serve OHP members through a delegated capitated arrangement with PacificSource in Marion and Polk counties, (meaning a fixed payment per member, per month). Kaiser Permanente also participates as a fee-for-service primary care provider under PacificSource in Lane County and contracts as a dental provider for Health Share of Oregon members in the Portland metropolitan area.
Quality
Kaiser Permanente Plan Partner contracts require our participation in the Oregon Health Authority Quality Incentive Program improvement. The metrics are set by the Oregon Health Authority each year and as of February 2024, we are projected to meet 8 of the 12 measures.
State Program Spotlight
Kaiser Permanente provides several Medicaid benefits that help address social needs and improve outcomes for our members, especially those with the most complex needs.
The health-related social need benefits we offer include:
Climate Support:
- Payment for devices that maintain healthy temperatures and clean air, including air conditioners, heaters and air filters
- Mini refrigerators to keep medications cold during a power outage
- Portable power supplies to keep medical devices running during a power outage
Housing Support:
- Rental assistance for up to 6 months
- Home modifications (e.g., ramps, handrails, environmental remediation)
- Pre-tenancy and tenancy support services (e.g., housing application, moving support, eviction prevention)
- Housing-focused navigation and/or case manager
Nutrition Support:
- Medically tailored meals for people with serious health conditions that need nutrition support to improve outcomes. This benefit requires a referral to a registered dietitian from a health care provider.
- Nutrition education to help members learn how to make informed choices and improve health through nutrition
Social Health
Many Kaiser Permanente members struggle with inadequate housing, hunger, financial stress, and other circumstances that create barriers to good health. Kaiser Permanente works proactively to identify our members with these and other adverse social needs and to connect them to community-based programs and government assistance-programs that can support their well-being.
Safety-Net Partnerships
Kaiser Permanente is committed to building partnerships with the health care “safety net” — institutions that play a critical role in delivering health care for the uninsured and underserved. Through grants, training, and technical assistance, we work with safety-net hospitals and health centers to help these institutions reach those who are low-income, uninsured, or under-resourced in our communities, and move the needle in eliminating health disparities. We do this by investing in quality improvement and other support efforts that aim to transform care and improve health access for those most in need.
Social Health Screening and Identification
Kaiser Permanente uses standard social health screening questions and data analytics to identify members vulnerable to food-insecurity, homelessness, financial strain, and other adverse social factors. By expanding social health screenings across an increasing number of clinical settings and member service touchpoints, with a focus on high-risk populations, Kaiser Permanente is steadily increasing the number of members screened for social needs every year. We screened nearly 3 million members for social needs in 2024, including 32% of our Medicaid members. These screenings and other data sources helped us identify over 1 million members with social needs and connect nearly 500,000 members to public benefits and community-based programs that support overall health. The Kaiser Permanente Community Support Hub™
The Kaiser Permanente Community Support Hub™ is dedicated to helping people meet their basic needs. The Hub operates proactively, using text, email, and phone calls to encourage members to complete social health screenings and to offer help finding and enrolling in community-based resources and government assistance programs that support overall health. The hub also provides on-demand services, including an online directory of resources that anyone can use to search for local programs that help with housing, food, paying utility bills, and more.
Medical Legal Partnerships
Working with local legal aid organizations in our communities, our care teams help patients facing housing-insecurity receive legal help at no cost. These medical-legal partnership programs build the capacity of the legal services sector and increase access to legal services to prevent people and families from losing their homes. This program targets low-income members and patients with housing related legal needs. In 2024, legal consultation was provided to over 1,000 patients across our national footprint.