The Oregon Health Authority increased CCO capitation payments by an average of 10.2% for 2026 — the largest rate boost in recent memory — but dental providers in the Portland metro area got the opposite: directed payments were eliminated in the tri-county region. The rate increase, driven primarily by surging behavioral health costs in the post-pandemic era, signals OHA's priorities clearly. Behavioral health is getting more resources. Dental is not.

The numbers tell a two-speed story. CCOs have paid significantly more than anticipated for behavioral health services in recent years, and OHA is responding with higher capitation rates and expanded behavioral health directed payments. Meanwhile, dental directed payments — supplemental payments above base capitation designed to improve dental access for OHP members — were removed for Multnomah, Washington, and Clackamas counties in 2026. OHA is also narrowing eligibility for enhanced behavioral health directed payments to team-based care providers specifically.

This creates a structural imbalance. Behavioral health investments are necessary and long overdue. But removing dental directed payments in the state's most populated region, where dental access for Medicaid patients is already constrained, risks widening the gap between medical and dental care in Oregon's integrated health system.

What this means for your practice: If you serve OHP patients in the Portland tri-county area, the removal of dental directed payments is a direct hit to your reimbursement. Review your CCO contracts to understand the exact financial impact. Practices operating on thin margins with heavy OHP patient panels may need to reassess their payer mix strategy. The behavioral health investment does create one opportunity: integrated practices that can offer co-located behavioral health and dental services may be better positioned for OHA's evolving funding model.