Care Oregon Merger?
Mid Valley Health Care Advocates (MVHCA) is a 501 (c)(3) organization whose mission is to
“...establish a publicly funded, equitable, affordable health care system for all people in
Oregon…”. MVHCA advocates have been working to achieve an equitable healthcare system in
Oregon for decades. Our members include physicians, nurses, and other health care providers
with over 100 years of combined experience. Some of our medical providers have been
employed with large group practices, and some of our medical providers have owned and
worked for small private medical businesses. Other members of MVHCA include Medicaid and
Medicare patients, people with disabilities, as well as college students many of whom are on
Medicaid wondering how they can afford health care in Oregon.
We have real concerns about the upheaval that the merger will create in other regions of the state
including Clackamas, Columbia, Tillamook, Jackson, Multnomah and Washington counties.
While no providers in our region would be directly affected by the proposed CareOregon merger
with SCAN, patients from our community may be directly affected as many patients are referred
out of the mid-valley community. In 2015 we watched as Trillium Community Health Plan, a
CCO in Lane County and a recognized leader for innovative approaches and outstanding
coordination of community-based healthcare was bought outright by Centene a national health
insurance corporation. A proposed “forward looking” smooth transition was very hard on
Oregon Medicaid patients, in particular the disabled population. Taxpayer monies flowed
through to Centene and out of Oregon. In 2022 United Health Care “quietly” purchased Oregon
Medical Group in Lane County. The transaction was NOT quiet for the affected patient
population. For several months OMG closed their offices to patient care every afternoon while
they learned how to manage the computer system that UHC required for all patient transactions.
In the midst of a Pandemic, disabled Medicaid patients were being sent to the Peace Health
hospital ED for primary care evaluation. Some of us had family members who were caught in
this troublesome situation. Given this history, we have serious concerns as taxpayers that the
proposed merger of CareOregon with SCAN California will create significant upheaval for
Oregon patients, particularly those on Medicaid and more particularly those who are disabled
based on our “lived experiences”.
The proposed merger of CareOregon with SCAN California raises several serious questions that
need to be addressed and answered before a decision is made. There are several “forward-
looking statements" made in the application document that may or may not come to pass.
Unfortunately, due to the proprietary and confidential nature of much of the data that is
available, answers are difficult to find in reviewing the organizational chart or the application for
merger documents. In addition, the public is ill prepared to find specific answers to their
questions. In the application document SCAN states that the merger will allow for more specialty
care for the Medicaid patients of CareOregon. Yet the documents do not state how they are
going to accomplish such an important achievement. Where will SCAN find the specialists to
meet the needs of the CareOregon patients given the shortage of specialists nationally? If the
specialists are in another state how will CareOregon patients be able to access that specialist?
Many of us ask “Why is SCAN so interested in CareOregon that SCAN has applied for a
merger”? These two corporations have different foci. SCAN focuses on providing Medicare
insurance plans to the elderly in California, Arizona, Texas and New Mexico, and with an
expressed desire to market those plans in Oregon and Washington; whereas, CareOregon is
focused on current healthcare needs of Oregon Medicaid patients and promoting health equity.
CareOregon has stated “CareOregon does not anticipate any changes to current services in
Oregon and plans to keep current management and staffing.” Why will CareOregon transfer
a total of $145 million (primarily taxpayer) dollars to form HealthRight and a Charitable
Foundation to better serve clients, when it appears from the available documents, that SCAN is
most interested in the flow of taxpayer money from Oregon to the corporate offices of SCAN so
they can expand their corporation?
Other questions are as follows:
1. How will the merger of CareOregon and SCAN California benefit the clients of CareOregon
who are primarily Medicaid or Medicaid/Medicare dual eligible persons?
2. How will the merger of CareOregon and SCAN California improve equity in healthcare for
the clients of CareOregon?
3. How will the transfer of $120 million by CareOregon to SCAN impact CareOregon’s
operations and how will this payment benefit clients in a better way than these clients are already
benefiting? Please be specific.
4. How will the payment of an additional $25 million dollars to form a Charitable Foundation
affect patient care or provide additional benefits to CareOregon clients? Please be specific.
5. What will happen to the $1 billion dollar reserve owned by Care Oregon after the merger?
6. What specific tangible service improvements would result for CareOregon clients?
7. While CareOregon would retain its Board of directors and have four members of the SCAN
HealthRight Group Board post-merger, who will have control over the budget and use of the
funds generated byCareOregon?
8. How will Oregon taxpayers be able to trust OHA when CareOregon operating revenue and net
assets leave the state. (In 2020 CareOregon reported $2.4 billion in operating revenue and had
net assets of $712 million.) It must be remembered that these are primarily taxpayer generated
dollars.
We ask that until these questions of what happens to the money are answered, that the merger not
be approved. It is hoped that OHA has learned the imbalances these types of mergers can entail,
based on the merger of Centene and Trillium as well as the merger of United Health Care with
Oregon Medical Group in Lane county several years ago, and how those mergers/acquisitions
disrupted medical care in that community from which it is still recovering.
Oregon is among several other national leaders in developing an equitable affordable high
quality healthcare system for its people through the CCO model. The proposed merger between
SCAN and an Oregon CCO is likely to bring more harm than good as Oregon endeavors to move
forward as a leader in state based healthcare. We forsee significant disruptions for the patients of
CareOregon if this merger is approved.
Mid-Valley Health Care Advocates
Mark Weiss, Chair
Bruce Thomson, MD
Karen Christianson, JD
