Mario Gonzalez/KFOR
·5 min read
OKLAHOMA CITY (KFOR) — Oklahoma’s new comprehensive delivery system for more than 600,000 SoonerCare members, SoonerSelect, remains focused throughout the transition. The main goal is increasing access to services and improving health.
Oklahoma’s health and dental plan partners are completing health screenings to establish strong care coordination for members, supporting local organizations and distributing millions of dollars to Oklahoma providers.
OKLAHOMA NEWS: Doctors claim they are not getting paid, can’t see patients with SoonerSelect rollout
“Oklahoma is a little over two months into the SoonerSelect implementation, and members are already taking advantage of the numerous extra benefits the plans provide,” said Ellen Buettner, OHCA Chief Executive Officer. “The plans assist members to pay their utility bills, obtain secure housing and access healthy meals to address food insecurity. The flexibility afforded in this public-private partnership is just one of many key benefits made possible by this transition. We are bringing life-changing support to Oklahomans who need it most.”
“Medicaid reform isn’t optional. Through SoonerSelect, we approached it in the most fiscally conservative and efficient way possible. SoonerSelect is providing an additional $500 million for hospitals across the state, creating new taxpayer protections, and holding down costs for patients and the state,” said Governor Kevin Stitt. “I am proud of the way OHCA has managed this transition, and while there will always be bumps in the road when rolling out programs of this size, Ellen Buettner and OHCA have been responsive and strategic in rolling this out.”
Key Achievements in SoonerSelect Implementation:
Over $230 Million in Medical Claims Paid: Since April 1, more than 1.3 million medical claims totaling over $230 million have been paid to providers. These claims payments include, but are not limited to:
$71M to hospitals
$31M to behavioral health practitioners
$100M to physical health providers, including physicians and mid-level practitioners
Over $18 Million Dental Claims Paid: More than 100,000 claims totaling $18 million in dental claims have been paid since Feb. 1
$252.4 Million Enhanced Hospital Payments: $252.4 million in first directed payments have been made to Oklahoma hospitals.
30,000 Health Screenings: Contracted entities have completed approximately 30,000 health screenings for members to establish care coordination plans. SoonerSelect provides enhanced, wraparound benefits to improve health care outcomes and align a member’s medical and dental needs.
Extra Benefits Utilized: Members have utilized extra benefits provided by the plans.
Delivery of 434 meals post-discharge from the hospital.
Referral of 1,517 members to the YMCA.
Providing 336 hours of tutoring services.
Addressing infant care through newborn care kits and providing car seats and cribs.
Community Engagement: Contracted entities hosted hundreds of member outreach events, including on-the-ground support in areas affected by recent severe weather and new member events to educate members on extra benefits.
Local Partnerships:
Aetna Better Health of Oklahoma partnered in opening two new Workforce Innovation Talent Centers (WITCs) and one Community Resource Center to improve access to workforce training and services to the community. Members will have access to comprehensive health and supportive services to help them take proactive steps toward a healthier future.
Humana Healthy Horizons partnered with Volunteers of America to provide a program in southwest Oklahoma that provides support and treatment for pregnant women and postpartum women going through addiction and substance use disorder.
Oklahoma Complete Health has established Health Equity Zones (HE Zones). The HE Zones model is a national best practice to address disparities through local engagement in areas experiencing the greatest needs. This program provides interventions to support members in partnership with local organizations.
Provider Financial Assistance: Oklahoma is one of a few states offering financial assistance to providers needing additional support during this transition.
Provider Transition: Over 60,000 providers have transitioned to serving members through SoonerSelect.
Robust Monitoring: OHCA receives over 250 reports monthly to ensure compliance with monitoring and oversight standards.
Looking Ahead:
Additional Enhanced Payments: An additional $500 million in supplemental payments will be distributed to Oklahoma hospitals annually, increasing total provider supplemental payments to $1.2 billion annually.
New Provider Payment Program: An additional $100 million will be distributed annually to Oklahoma providers, including physicians, mid-level practitioners, and behavioral health providers. This program incentivizes early intervention behavioral health screenings, after-hours access to services, and well visits.
Increased Preventive and Primary Care Spending: Contracted entities are required to spend 11% on primary care, compared to the current 5% spent by OHCA.
Quality Improvement: SoonerSelect’s primary focus is on quality of care and increasing access. These goals are exemplified through the contracted entities’ performance plans that are centered on critical needs like social determinants of health coordination, comprehensive diabetes care and childhood obesity.
OHCA maintains the supervision and authority over Oklahoma’s Medicaid program, including SoonerSelect, eligibility and program funding. During the carryout process of SoonerSelect the OHCA has prioritized the responsibility as a protector of public trust and remains committed to holding each contracted partnership accountable to ensure compliance with state, federal, and contractual obligations.
“SoonerSelect builds on the existing foundation in place at Oklahoma’s health agencies to leverage the infrastructure and expertise of these health and dental plans. We continue to be on the lookout for the places we need to adjust to ensure no one is left behind,” said Buettner. “We have held dozens of townhalls as well as in-person office hours and virtual office hours so that every provider is equipped to be successful with SoonerSelect. We have also made transitional financial assistance available to help providers bridge the gap if that support is needed.”
Providers that are needing support are encouraged to reach out to OHCA. Providers can fill out a dedicated form in order to explore financial assistance, access SoonerSelect-specific provider resources and guides, or contact SoonerSelect@okhca.org with any questions pertaining to SoonerSelect.
Members have through June 30, 2024 to switch to a different plan, by logging into MySoonerCare.org. Members of SoonerSelect that have questions can call the SoonerCare helpline at 800-987-7767 or by contacting their SoonerSelect health plan.
Copyright 2024 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
For the latest news, weather, sports, and streaming video, head to KFOR.com Oklahoma City.
