Aspire Wellness, a new outpatient behavioral health clinic in Springfield, aims to support adults with intellectual and developmental disabilities, but remains unoccupied. Founder and CEO Cindy Koza stated that despite having 40 individuals on a waiting list, the clinic has yet to open due to protracted administrative delays. The approval process with the Oregon Health Authority took about a year, and complications arose with contracting Trillium Community Health Plan, which oversees Oregon's Health Plan in Lane County.
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Trillium became the sole Medicaid insurer in Lane County this year after PacificSource exited, citing financial losses. Koza highlighted the urgent need for services as some patients face wait times exceeding a year for mental health care. She noted that the few therapists available often lack the understanding necessary for individuals with developmental disabilities.
Trillium, a subsidiary of Centene Corporation, has been operating in the area since Oregon adopted a Coordinated Care Organization (CCO) model in 2012. Koza remarked that Trillium informed her clinic it is not accepting new outpatient behavioral health facilities into its network currently, which significantly limits Aspire's ability to treat Medicaid patients in the region.
In a statement, Trillium affirmed that most PacificSource members retained their mental health providers during the transition and maintained that its current network meets the needs of members while adhering to state standards. Lane County Commissioner Laurie Trieger noted concerns from both healthcare providers and patients regarding contracting issues following the switch to Trillium as the sole Medicaid insurer. She emphasized the ongoing healthcare shortages in the area, particularly in behavioral health, expressing concern that complications could further exacerbate this issue.
Other clinics, like WellMama in Eugene, are facing similar contracting difficulties. Executive Director Lyndsie Leech explained that the nonprofit, which provides various supportive services, could not secure a new contract with Trillium after being assured of a bridge contract during the transition.
Jesse Nelson, executive director of Connected Lane County, reported being unable to reach an agreement with Trillium after two years with PacificSource. He noted that this disrupted service provision for youth support specialists, who help young adults navigate healthcare and address wider issues affecting their well-being.
Trillium responded that it includes traditional health workers in its coverage and is working on expanding access to services. The company attributed its decisions regarding network limitations to member needs and overall provider capacity. The Oregon Health Authority stated that Trillium has met access benchmarks during its transition; however, it will work to rectify any shortcomings identified in future evaluations.