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Oregon Health Authority

Health-Related Services

Overview

Health-related services (HRS) give coordinated care organizations (CCOs) a way to address social determinants of health. For CCOs to use federal Medicaid funds to pay for HRS, they must comply with state and federal criteria, including the OHA HRS Brief, Oregon Administrative Rules (OARs 410-141-3500 and 410-141-3845), and the Code of Federal Regulations (45 CFR 158.150 and 45 CFR 158.151). The history of HRS and how it has evolved is detailed in the OHA HRS Brief. 

HRS are non-covered services that complement covered benefits under Oregon's Medicaid State Plan to improve member and community health and well-being. There are two types of health-related services: 
  • Flexible services, which are cost-effective services provided to a member to complement covered benefits, and
  • Community benefit initiatives, which are community-level interventions focused on improving population health and health care quality. These initiatives include members, but are not necessarily limited to members.

HRS spending

CCOs are required to report annual HRS spending to OHA through their Exhibit L Financial Reports (template available on the CCO Contract Forms webpage). OHA reviews the annual CCO Exhibit L HRS expenditures to ensure expenditures meet HRS criteria. The most recent spending summaries are available here, and prior year summaries can be requested by reaching out to health.relatedservices@oha.oregon.gov:

HRS office hours

General CCO questions
2025 sessions: Jan. 3, April 4, July 11, Oct. 3 (9:05–9:30 a.m. all sessions)

HRS CCO memos 

HRS information for OHP members

If you are an Oregon Health Plan member and enrolled in a CCO, learn how to request flexible services (multiple languages available).

HRS guidance

General guidance
  • Health-Related Services Brief (updated November 2022) – Defines health-related services, describes examples of health-related services used among CCOs, and explains how OHA incorporates health-related services into CCO payments.
  • Health-Related Services FAQ (updated December 2023) – Answers frequently asked questions (FAQ) about health-related services. This FAQ will be updated as additional questions are addressed.
  • Examples of Approved HRS Expenditures - English / Español (updated December 2023)
Cross spending program guidance Topic-specific resources
Reporting and evaluation

HRS learning opportunities

Webinars

​Join us for an overview of 2023 HRS statewide spending. Hear highlights from the annual spending summary, including total spending across all coordinated care organizations (CCOs) in flexible services, community benefit initiatives, and health information technology. Gain insights about CCOs' investments in key areas, like housing, behavioral health, economic stability and food access. The webinar will be most helpful to CCO staff who work on implementing HRS within their communities. 

  • Thursday, December 12, 2024 
  • Noon–1 p.m. Pacific Time 
  • Register here (After registering, you will receive an email from Zoom containing information about joining the meeting.)  ​


​Join us for an overview of a new braided funding concepts document. This document will provide example scenarios illustrating how CCOs can braid multiple funding streams, including health-related services (HRS), Supporting Health for All through REinvestment (SHARE) and in lieu of services (ILOS). Using a community-based approach, we'll show example scenarios of Oregon Health Plan members navigating their community context and services, and how a CCO can strategically address community-specific opportunities and leverage community strengths to support them. This webinar will be most beneficial for CCO staff overseeing Medicaid spending programs in their communities. 

​Join us to learn about communicating with your CCO's community partners about various Medicaid spending programs — including health-related services (HRS), Supporting Health for All through REinvestment (SHARE) and in lieu of services (ILOS). We will share a new resource for CCOs that aims to simplify the program requirements and descriptions. This webinar is sponsored by the OHA Transformation Center in partnership with Oregon Rural Practice-based Research Network (ORPRN).

  • Audience: This webinar will be most beneficial for CCO staff who oversee these spending programs and programmatic work with community partners. 
  • Slides
  • Recording​
  • Handout​ (for CCOs to edit and share with community partners)

​Slides are available for a three-part technical assistance series on centering equity in health-related services (HRS) flexible services programs. These hands-on work sessions were intended to help coordinated care organization (CCO) staff plan and integrate equity-centered strategies into their HRS programs. The series builds on recent webinars that showcased Health Literacy and Equity in HRS Flex. All CCO staff are welcome, but the content will be particularly relevant for HRS flex program lead staff.​

  • Pre-series webinar: ​​​Centering equity in HRS flexible services 
  • Part 1: Making HRS flex more accessible to members and providers – View slides
  • Part 2: Addressing community needs through HRS flex – View slides
  • Part 3: HRS flex policies and procedures – View slides​​

​Cliff Coleman, MD, MPH, presents an overview of health literacy, discusses the role of health literacy in advancing health equity and provides CCOs with strategies to effectively communicate with Medicaid patients. Dr. Cliff Coleman is a practicing family medicine physician at Oregon Health & Science University and national expert in health literacy and doctor-patient communication. 

​

Events

10/9/2024
Centering Member and Community Perspectives in HRS, SHARE and ILOS Spending Programs
  • October 9, 2024
  • Salem Convention Center (in-person only)
  • For CCO staff working in HRS, SHARE, ILOS, SDOH-E and related spending efforts.
  • Convening materials​​
​

9/13/2023

​See the event page​.

CCO HRS Policy and Procedure (P&P) Submissions

Contact

If you have questions, please email the OHA health-related services team at health.relatedservices@oha.oregon.gov

Note: The OHA staff who manage this email account do not have access to OHP member information and are not able to help request health-related services for members.