Unite Us Enables CBO Reimbursement Under Oregon’s 1115 Medicaid Waiver

Connect Oregon streamlines Medicaid billing for community-based organizations (CBOs) using Unite Us Payments, increasing access to vital social services for Medicaid members.

New York, New York–March 26, 2024 – Unite Us, the nation’s trusted technology partner for social care transformation, announces the adoption of its scalable payments solution by nine Coordinated Care Organizations (CCOs) across Connect Oregon, the state’s coordinated social care network, to implement the Health-Related Social Needs (HRSNs) climate benefit. Launched this month, the initiative will provide qualified community members with the equipment necessary for addressing challenging climate events, under the state’s 1115 Waiver demonstration.

Unite Us’ Payments will play a critical role in enabling the CCOs to streamline the community reimbursement process, build capacity for community-based providers, and expand access for Medicaid members. The decision was driven collaboratively by the CCOs through the Oregon Payments Workgroup, convened by the Oregon Health Leadership Council to strategize on the implementation of the climate benefit, and marks a pivotal point for the Connect Oregon network as it expands the ability to serve Medicaid members in their communities.

“InterCommunity Health Network decided to join the Oregon Payments Workgroup to collaborate with other CCOs to understand, navigate, and standardize the complexities of the new HRSN climate-related benefits,” said Benjamin Myrstol, Senior Project Manager at Samaritan Health Plans. “The workgroup has been valuable in ensuring that all the CCOs are following similar workflows in the Unite Us Platform to speed up build and implementation timelines and ensure maintenance is more sustainable. In addition, the standardized build in Unite Us will help the CCOs with transitional care for members who move from one CCO to another.”

Part of Oregon’s 1115 waiver demonstration taking place from 2022 to 2027, the climate benefit is the first of three new HRSN benefits using the expanded technology infrastructure, setting the stage for transformative change. It will be followed by support for housing in November 2024 and nutrition in January 2025, underscoring Oregon’s dedication to holistic care.

Integrated with Unite Us’ core closed-loop referral platform, the payment capability will enable reimbursement to community-based organizations (CBOs) for provided services at scale, while simultaneously measuring the impact of social care funding. As HRSN benefits roll out, this solution will support both CBOs and funders to more efficiently process invoices and social care claims by automating complex coding and rate information and reducing the risks of costly denials and rejections.

“For years we’ve embraced the notion that unmet social needs contribute to poor health, and this benefit has the potential to significantly impact the overall health of our most vulnerable members,” said Juliana Landry, Vice President of Health Systems Performance at Umpqua Health Alliance. “In our efforts with HRSN payments, our goal is to streamline the payment experience for our members as well as our CBOs, particularly those spanning multiple CCO regions. This collaboration provides an opportunity to work together with our fellow CCOs to leverage a unified and scalable solution.”

Unite Us has collaborated with CCOs and health systems in Oregon since 2018 to streamline Medicaid billing for community-based organizations using Unite Us Payments, which increases access to vital social services for Medicaid members. Unite Us has long-standing partnerships with the organizations involved, including PacificSource, Health Share of Oregon, Intercommunity Health Network COO, Umpqua CCO, and the Office of Resilience and Emergency Management, facilitated by the Oregon Health Leadership Council.

Now, the adoption of the new capability will empower these organizations to get Medicaid members access to new HRSN benefits and channel funding into local communities, representing a major advancement in our joint effort to revolutionize healthcare reimbursement systems and extend their influence across the state.

“We’re excited to celebrate our payment solution partnerships in Oregon, elevating social care to parallel clinical care and channeling funding into local communities,” said Taylor Justice, Co-Founder and President of Unite Us. “We are committed to revolutionizing community-based healthcare reimbursement systems and supporting our partners in innovative solutions they bring to the space.”

The Oregon Payments Workgroup will oversee the rollout, ensuring efficient implementation and maintenance of HRSN benefits through standardized workflows and streamlined processes that benefit both CCOs and their members. The Workgroup, spearheaded by Intercommunity Health Network, exemplifies the collaborative spirit behind Connect Oregon.

“211info’s Coordination Center has been at the forefront of this movement, working alongside Unite Us and Connect Oregon partners for six years,” said Dan Herman, CEO of 211info. “Our focus remains on empowering communities and facilitating seamless access to vital services, amplifying the impact of Oregon’s healthcare transformation.”

As Oregon continues to prioritize community-driven investments in health equity, Unite Us remains committed to advancing whole-person care coordination and fostering interconnected networks of care providers.

Nonprofits and community-based organizations seeking to join the Connect Oregon network can connect through uniteus.com/contact/.