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health22h ago
Providence Oregon CEO Discusses “Joint Decision” With Insurer to Restrict Access to Specialty Care
- Providence Oregon and CareOregon limit most new referrals to Providence specialists for CareOregon Medicaid members, affecting over 200,000 Portland-area patients.
- Burrows says the change is a joint decision with CareOregon and aims to deliver high-quality services more efficiently.
- Some carve-outs remain, and urgent care continues; care for current Providence specialists may persist for certain Medicaid patients.
- CareOregon members face potential longer waits or limited access to specialty care due to network changes.
- Burrows emphasizes a plan to ensure no patient currently in care has their treatment interrupted.
- The arrangement affects 60,000 Medicaid members on Providence’s in-house plan and other insurers in the region.
- The decision comes amid financial pressures shaping access to specialty care in Oregon.
- The providers left room to reverse course or adjust the network if adequacy concerns persist.
- CareOregon is Oregon’s largest Medicaid plan, routing many members to federally qualified health centers for primary care.
- The change drew on a broader interview with WW describing the joint decision and its implications for access.
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