Oregon's Health Authority has set 2027 payment rates for coordinated care organizations managing Medicaid benefits statewide, granting the health plans an average increase of 6.1% per member per month compared to 2026.
The 15 organizations coordinate care for about 1.4 million people enrolled in the Oregon Health Plan, including low-income adults, children, pregnant women, elderly adults, and people with disabilities. Starting next year, they will receive an average of $627.68 per member per month for medical, dental, and behavioral healthcare services.
The rates reflect several factors the Health Authority considered during the rate-setting process, including anticipated enrollment declines from upcoming federal changes, rising healthcare costs, and modifications to covered benefits and payment policies. The 6.1% increase excludes a temporary state investment in maternity care that was added in 2026; when that is included, the overall rate increase is 5.6% over the prior year.
The Health Authority developed the rates using financial data from 2025 and early 2026, when the organizations' profit margins improved to 0.8% in 2025 from just 0.001% in 2024. Preliminary data from early 2026 indicates the organizations' financial health has continued to improve.
The rate-setting process was governed by Oregon House Bill 4039, enacted in March, which required the Health Authority to use a more transparent, data-driven approach. The authority submitted the rates to the U.S. Centers for Medicare & Medicaid Services for approval by the end of the year.