Usually, OSC_OUT is a CMOS pin like any other, but unlike any other, it has an unusually weak (and programmable) output drive strength, and analog feedback to bias it near VDD/2.
This allows it to drive a minimal AC voltage into the crystal, which typically has an impedance on the order of ~100 ohms, or ~1.5kohms, or ~100kohms (depending on series vs. parallel vs. tuning fork crystal styles).
By the way, the loading capacitors' reactance is always on the order of the crystal's ESR. For example, a 20MHz, 100 ohm crystal might specify 18pF loading, which means you need two 36pF capacitors, one to ground on either side (as seen by the crystal, they act in series, hence 36/2 = 18pF loading). 18pF is 442 ohms at 20MHz, within a factor of 4.4. (Note that actual loading capacitor *components* are smaller still, because the pins have capacitance too, which act in parallel with them. This should be documented somewhere in the IC datasheet. Just subtract it out from each capacitor, then use the result for the physical components, give or take maybe 10 or 20%.)
If it were a full-strength CMOS output, notice the capacitor wouldn't matter, because it would always be pushed around by the much stronger pin. This is almost never done. In fact, though it's rarely documented as such -- this is strongly hinted at by the ICs that require an external series resistor (usually around, guess what, 1.5kohms!) from OSC_OUT to the crystal.
That is, if the IC does not indicate an external resistor, then it has a controlled (weak) pin drive output. If it does require an external resistor, then it is probably a regular CMOS output pin, and can be used and shared as any CMOS clock output pin. (But test it, first. It's probably not documented as such.)
In any case, the other side of the crystal (OSC_IN) couples to an analog biased Schmitt trigger, which drives the OSC_OUT pin (at whatever drive strength it's designed/configured for). The sensitivity is usually quite good (~0.1V?), so little power is required to drive the crystal, keeping efficiency good.
Tim