Henderson says there was never any question that Central Oregon’s CCO would be a nonprofit, in part because the nonprofit structure reinforces the CCO’s mission-driven nature.
“Our mission is serving a population that has a tough time,” not focusing on how to make a profit and “give bonus checks” to executives, Henderson says.
Being a nonprofit allows the Central Oregon Health Council to do things such as cap administrative costs at 8%, and direct any savings back toward services and programs helping Oregon Health Plan patients.
In some ways, the four nonprofit CCOs could weather growing pains better than others. They will be tax-exempt and are accustomed to the transparent reporting now required by the Oregon Health Authority. Also, nonprofit laws dictate that the organization be controlled by a board of directors, similar to the governing board each CCO must have.
That board must have representation from each organization participating in the CCO, including county government, local hospitals, independent practice associations, mental health and substance abuse treatment providers. The structure ensures that each health organization in the CCO has an equal voice, participation and influence in the CCO’s development — which will be crucial if CCOs function as intended.
At the end of the day, advocates and CCO leaders alike think it doesn’t matter what business structure a CCO has as long as they’re able to get the job done.
“The main issue — however these CCOs organize — is whether they are going to be mission driven, and whether they are going to fulfill the vision of person-centered care,” says John Mullin, Oregon Law Center lobbyist, who has followed the development of CCOs.