February 10, 2016
OHCA Contacts: Jo Kilgore - (405) 522-7474, Jennie Melendez - (405) 522-7404
ABD RFP development delay
The Oklahoma Health Care Authority (OHCA) will resume ABD stakeholder meetings in May as part of the Request for Proposal (RFP) development for the ABD Care Coordination program. The two-month delay in the timeline is due, in part, to the need for additional time for the actuary to develop rates. The development of actuarial rates is a critical component of the RFP development. The first deliverable from the actuary is due in May of 2016.
Also, as OHCA staff began to delve into the details of the RFP development, additional sections were identified as needed. This has also increased the amount of work and time needed for the project.
Due to the extended timeline of the RFP development, the quiet period required by state of Oklahoma procurement law is also extended. Therefore, the OHCA is cancelling the March and April stakeholder meetings.
November 30, 2015
OHCA Contacts: Jo Kilgore - (405) 522-7474, Jennie Melendez- (405) 522-7404
Agency selects care coordination model for Aged, Blind and Disabled populations
OKLAHOMA CITY – Following five months of intensive planning, leaders of the Oklahoma Health Care Authority (OHCA) announced they will develop a Request for Proposals (RFP) aimed at contracting for a fully capitated, statewide model of care coordination for Oklahoma Medicaid’s Aged, Blind and Disabled (ABD) populations.
The RFP is the result of HB1566, passed during the 2015 Oklahoma Legislative session. The bill charged OHCA with issuing an RFP for care coordination models for its ABD populations. The intent of the legislation is to provide better access to care, improve quality and health outcomes and control costs.
"Oklahomans with complex medical needs can benefit greatly from a care coordination model that gives them one effective team whose job is to help them navigate the medical world of doctors and specialists in every field. One effective team that helps them make their appointments, get their medicine, and get them on the road to better health. One effective team who helps them receive needed specialized services that could prevent a hospital stay. Our goal is a healthier Oklahoma!" said state Sen. Kim David, R-Porter, co-author of the measure and chair of the Senate Appropriations Subcommittee on Health and Human Services.
“The goal behind House Bill 1566 is to improve health outcomes for the aged, blind and disabled while maximizing limited resources,” said state Rep. Glen Mulready, R-Tulsa, co-author of the measure and chair of the House Insurance Committee. “We believe we can provide better quality healthcare at a lower cost for this particular population of Oklahomans by introducing competition into the system. We have just completed a very extensive review process that included hundreds of providers and participants. I am very pleased that we have reached this point in the process, and I am excited to work with the Health Care Authority as we move forward.”
OHCA solicited input on potential care coordination models from a wide variety of stakeholders. Over a three-month period, OHCA and its consultant, Pacific Health Policy Group (PHPG), held meetings with ABD members, their families, providers, advocates and other stakeholders throughout Oklahoma. OHCA also gathered recommendations through a Request for Information (RFI) that drew responses from 22 Oklahoma-based and national health care organizations interested in serving ABD members.
After careful review and analysis of the information received through the various venues for stakeholder engagement, and through responses to the RFI, the OHCA has chosen a fully capitated, statewide model of care coordination. OHCA believes this model will meet the intent of the legislation by providing the highest quality of care for the ABD populations, while helping to control costs and improve health outcomes. RFP development will begin in December with an anticipated release date of June 2016.
More information about the process is available on this page.
The Oklahoma Health Care Authority (OHCA) administers two key health programs for the state. The first is SoonerCare, Oklahoma’s Medicaid program. SoonerCare works to improve the health outcomes of Oklahomans by ensuring that medically necessary benefits and services are responsive to the health care needs of our members. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. OHCA strives to educate and engage our current 827,118 members regarding personal responsibilities for their health services utilization, behaviors, and outcomes in partnership with a state-wide network of 44,288 providers. For more information, visit www.okhca.org or www.insureoklahoma.org.