CY2025 Coordinated Care Organization-Long Term Services and Supports (LTSS) Memorandum of Understanding Annual Report and Guidance

Sep 1, 2026

CY2025 CCO-LTSS MOU Annual Report and Guidance outlines the annual reporting areas for Coordinated Care Organizations responsible for Oregon members receiving Medicaid-funded long-term services and supports. It explains the purpose of shared accountability between the Oregon LTSS system and CCOs to improve care coordination, transitions, quality outcomes, and to reduce duplication. It defines Oregon’s LTSS population under OAR 410-141-3500, covering long-term care and home and community-based services, and lists shared accountability goals and MOU-required coordination processes.

LanguageEnglish

CategoryGeneral

FormatDOCX

Pages20

Reading Time7 min

AccessFree to download

Purpose/Scope of this Guidance

Oregon LTSS Population Definition

Long-term Care

Home and Community-Based Services

Shared Accountability Goals

Shared Accountability Goals for MOUs

CY2025 Coordinated Care Organization-Long Term Services and Supports (LTSS) Memorandum of Understanding Annual Report and Guidance Purpose/Scope of this Guidance: This document provides an overview of the annual reporting areas aligned with annual CCO-LTSS MOUs that are CCO’s responsibility for populations receiving Medicaid-funded LTSS in Oregon. This document is intended to provide guidance and technical support for the completion of CCO annual reporting, as outlined in the CCO Contract. See previously posted HYPERLINK "https://www.oregon.gov/oha/HSD/OHP/CCO/LTSS-MOU-Guidance-CY2025-26.docx" CCO-LTSS MOU guidance updated December 2024 for MOU specific requirements. The purpose of the MOU is to ensure that coordination between the Oregon LTSS system and the CCO creates alignment between the two systems to provide quality care, promote coordinated care planning and care transitions, produce the best health and functional outcomes for individuals, and reduce duplication and inefficiency through better coordination across systems. Oregon LTSS Population Definition: As set forth in OAR 410-141-3500: “Medicaid-Funded Long-Term Services and Supports (LTSS)” means all Medicaid funded services CMS defines as long-term services and supports, including both: (a) “Long-term Care,” the system through which the Department of Human Services provides a broad range of social and health services to eligible adults who are aged, blind, or have disabilities for extended periods of time. This includes nursing homes and behavioral health care outlined in OAR chapter 410, division 172 Medicaid Payment for Behavioral Health Services, including state psychiatric hospitals; (b) “Home and Community-Based Services,” the Medicaid services and supports provided under a CMS-approved waiver to avoid institutionalization as defined in OAR chapter 411, division 4 and defined as Home and Community-Based Services (HCBS) and as outlined in OAR chapter 410, division 172 Medicaid Payment for Behavioral Health Services. For additional information about the Oregon LTSS system administered through Oregon DHS please see “ HYPERLINK "https://www.oregon.gov/oha/HSD/OHP/Tools/Overview%20of%20Delivery%20System%20for%20Medicaid%20and%20Long%20Term%20Services.pdf" Overview of the Delivery System for Medicaid and Long-Term Services & Supports to Seniors and People with Disabilities” document. Shared Accountability Goals: Many low-income adults who need and use long-term services and supports (LTSS) have complex healthcare issues, including multiple chronic conditions to manage, and often have unmet social needs which can lead to poor health outcomes. Populations needing LTSS are among the fastest-growing populations covered by Medicaid. Oregon created a system of shared accountability between Coordinated Care Organizations (CCOs) and Oregon's Long-Term Care (LTC) system in 2013 to draw on the strengths of Oregon’s medical and LTSS systems to build collaboration as part of Oregon health care transformation. The framework’s intentions was developed to lead the way to greater integration and coordination between the CCO and LTSS systems while remaining consistent with and strengthening Oregon’s ORS 410 values to promote health, honor, dignity, and lives of maximum independence, and Oregon’s Triple Aim. Oregon also made policy decisions to exclude LTSS services from the CCO global budget and have LTSS services continue to be paid for directly by the Department of Human Services (DHS). CMS also clarified expectations for coordination with LTSS services in managed care rule updates, and now rules and contracts have been further updated to build on past successes. CMS has also increased focus to promote integrated care, especially for dual eligibles (people eligible for both Medicare and Medicaid) and members with long-term service and support needs while reducing duplication across systems. Communication between health systems and LTSS providers were two main focu

FAQs

What is the purpose of the CY2025 CCO-LTSS MOU guidance?

It provides an overview of annual reporting areas aligned with CCO-LTSS annual MOUs that are the CCO’s responsibility for members receiving Medicaid-funded LTSS in Oregon. It also offers technical support for completing CCO annual reporting.

How does Oregon define the LTSS population under OAR 410-141-3500?

“Medicaid-Funded Long-Term Services and Supports (LTSS)” includes CMS-defined long-term care and home and community-based services provided under CMS-approved waivers to avoid institutionalization.

What shared accountability goals are included in the MOUs?

MOUs require protocols for reviewing and prioritizing LTSS members, coordinated and aligned care across systems, tailored coordination in long-term care and HCBS settings, referral processes for LTSS assessments and planning, and mechanisms for communication, care planning, and care transitions.

Sep 1, 2026

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