State explores privatizing care for aged and disabled

Source: Warren Vieth, Moore American, October 28, 2015

…the Oklahoma Health Care Authority is exploring cost-saving options that could lead to partial privatization of the state’s $2.4 billion Medicaid program for aged, blind and disabled people.  The state tried that once before, and it didn’t work out. Costs escalated, companies dropped out, and the state pulled the plug. Supporters of the new effort predicted it might turn out better because of improvements in managed-care practices. Even if it does, however, advocates of the aged, blind and disabled said a new managed-care program could be highly disruptive for thousands of impaired Oklahomans who might be forced to switch doctors and adapt to new care regimens. … The 178,025 aged, blind and disabled Oklahomans who received health services in fiscal year 2014 accounted for 16 percent of Medicaid membership, but 47 percent of spending. … The current initiative was launched after the Legislature passed Mulready’s House Bill 1566 earlier this year. The bill directed the authority to request proposals from independent vendors who could coordinate health care for aged, blind or disabled people currently enrolled in SoonerCare, the state’s version of Medicaid. The bill was backed by three influential health care groups: Blue Cross Blue Shield of Oklahoma, the Oklahoma Hospital Association and the Oklahoma Association of Heath Care Providers, which represents for-profit nursing homes. …

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Worries Build As State Moves To Privatize Care For The Aged, Blind And Disabled
Source: Oklahoma Watch & Warren Vieth, KGOU, September 28, 2015

Even if it does, however, advocates of the aged, blind and disabled said a new managed-care program could be highly disruptive for thousands of impaired Oklahomans who might be forced to switch doctors and adapt to new care regimens. … The 178,025 aged, blind and disabled Oklahomans who received health services in fiscal year 2014 accounted for 16 percent of Medicaid membership, but 47 percent of spending. The state pays about a third of the cost. The federal government pays the rest.

OHCA looking into privatized, coordinated care
Source: Sally Asher, Enid News, September 24, 2015

Oklahoma Health Care Authority held a stakeholder meeting in Enid Wednesday night to gather thoughts, opinions and information on privatizing health care for aged, blind or disabled Medicaid consumers.  In the most recent session, the Legislature passed House Bill 1566, which directs OHCA to explore care coordination models for those individuals. Currently, the state contracts with providers through OHCA for their care, but under the new program, OCHA would work with third-party care providers. … Cohen said some things will not change with privatized care: eligibility for Medicaid and Medicare programs and services covered by those programs will stay the same. Some things that could change include an increase in care availability, service providers, the way payments are made and who authorizes such services.

MAXIMUS Awarded $23.5 Million Customer Relationship Management Contract for Oklahoma’s SoonerCare and Insure Oklahoma Programs
Source: BusinessWire, September 27, 2012

MAXIMUS (NYS: MMS) , a leading provider of government services worldwide, announced that it has signed a new contract with the Oklahoma Health Care Authority (OHCA) to operate a Customer Relationship Management (CRM) solution for the SoonerCare and Insure Oklahoma programs. The one-year contract includes five one-year renewal periods, for a total contract value of $23.5 million if all renewal periods are exercised. The contract was awarded on September 17, 2012 and the first contract term ends on June 30, 2013.

SoonerCare, the state’s Medicaid program, provides medical benefits to qualified individuals who have inadequate or no health insurance coverage. Insure Oklahoma provides employers with premium subsidies to help buy private market health insurance for low- to moderate-income employees. The program’s individual plan provides health benefits to employees whose workplace does not offer health insurance.