Oklahoma

Beginning in 2008, the Oklahoma Legislature passed Resolution 1058 in support of the patient-centered medical home (PCMH) and encouraged all health systems in Oklahoma to study and implement principles of the PCMH.  Chapter 1656 of the Session Laws created a Medical Home Task Force charged with studying PCMH implementation among commercial and public payers. Oklahoma Health Care Authority implemented a PCMH primary care delivery system in January 2009 for SoonerCare Choice members. This model incorporated a managed care component with traditional fee-for-service and incentive payments for medical homes.

Launched as one of the 17 Beacon Programs funded by the federal Office of the National Coordinator (ONC) for Health Information Technology, MyHealth Access Network - a non-profit coalition of more than 200 organizations in northeastern Oklahoma - used innovative health care technology and dissemination of impactful information to enhance the capacity of medical homes to coordinate care and improve patient health. MyHealth seeks to achieve per-capita cost savings through improved care delivery for under-served populations.  With an emphasis on access to specialty care and close regional disparities in health outcomes, MyHealth strives to show that diverse communities can achieve care that is high quality, affordable, efficient and results in healthier populations.

Oklahoma’s proposal for the State Demonstrations to Integrate Care for Dual Eligible Individuals includes multiple care coordination models for dual eligibles including:

  • Health Homes: A partnership between the State Mental Health Agency and the Oklahoma Department of Mental Health and Substance Abuse Services for management of members with mental health needs. A nurse care manager coordinates care with a team of providers, including community mental health center staff.
  • SoonerCare Silver: A care coordinator will serve as a “bridge” between Medicare and Medicaid programs and providers.  Interdisciplinary care teams will develop and implement a member-specific care plan.
  • Integrated Care Sites: Members receive care at a single site and are overseen by an interdisciplinary care team that includes the member, physician, nurse, and social worker. Providers receive blended capitation rate from Medicare and Medicaid.

 

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

Multi-Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Oklahoma Comprehensive Primary Care Initiative Multi-Payer Tulsa Region CMS Comprehensive Primary Care Initiative

State Legislation

Legislation Status Year
Chapter 1656, Session Laws of Oklahoma

The legislation created a Medical Home Task Force charged with studying PCMH implementation among commercial and public payers.

Active 2008
Resolution 1058

The legislation supported the patient-centered medical home (PCMH) and encouraged all health systems in Oklahoma to study and implement principles of the PCMH.

Active 2008

State Facts:

Population:
3,722,400
Uninsured Population:
14%
Total Medicaid Spending FY 2013: 
$4.8 Billion 
Overweight/Obese Adults:
67.9%
Poor Mental Health among Adults: 
34.3%
Medicaid Expansion: 
No 

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