The Exceptional Needs Care Coordinator in the Oregon Health Plan
Oregon designed several consumer protections for the SSI population and other aged and disabled beneficiaries in Medicaid managed care under the State’s 1115 waiver. The Exceptional Needs Care Coordinator (ENCC), a type of specialized case manager at the managed care plans, is a cornerstone of these consumer protections. The ENCC and other features of the Oregon Health Plan can effectively assist SSI and other aged and disabled beneficiaries in negotiating managed care and act as a counter balance to the inherent incentive to reduce services associated with managed care. States considering a similar program should look carefully at the lessons learned in Oregon about successes and limitations of Oregon’s program design and implementation.