The right model for Oklahoma
A Look At The Numbers provides information on how managed care organizations (MCOs) will partner with Oklahoma to provide care for a growing Medicaid population.
Modern Medicaid managed care enables Oklahoma to deliver higher quality care and improved health outcomes for Medicaid recipients, while managing healthcare costs.
The care people need, when they need it. That is the model of managed care.
A Medicaid expert on managed care
Hear from Tom Betlach, the former director of Arizona’s Medicaid program, on why managed care is right for states like Oklahoma.
Medicaid in Oklahoma
Oklahoma’s Medicaid program, SoonerCare, provides healthcare to many individuals facing economic and social barriers to help improve their health and well-being.
The right partnership for Oklahoma
SoonerCare can be at its best in partnership with modern MCOs, which can help Oklahoma deliver higher quality healthcare in new ways.
How MCOs are held accountable
Unlike the fee-for-service approach, the modern managed care model is measured against specific quality standards by federal and state governments. Modern MCOs are accredited and regularly reviewed using up to 69 quality measures by the National Committee on Quality Assurance (NCQA) as well as by state agencies.
Performance measures set by states ensure that modern MCOs deliver consistent, high-quality care that is aligned with state strategies to improve population health, while also providing competition and choice for recipients.
Citations
1 https://oklahoma.gov/ohca/research/fast-facts-archives.html
2 http://files.kff.org/attachment/fact-sheet-medicaid-expansion-OK
3 https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
4 https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/oklahoma-opioid-involved-deaths-related-harms
5 https://www.medicaid.gov/state-overviews/scorecard/postpartum-care/index.html
6 https://healthinsuranceratings.ncqa.org/2019/Default.aspx
7 https://medicaidplans.org/wp-content/uploads/2020/05/2020PR_MHPAStatement_HouseBill_May-15.pdf
8 https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/#:~:text=A%20number%20of%20large%20health,%2Dprofit%2C%20and%20government%20planssource:Source:
9 http://files.kff.org/attachment/Report-Medicaid-Managed-Care-March-Plans-and-Access-to-Care
A Look At The Numbers is an educational resource about Medicaid managed care, hosted and supported by Medicaid Health Plans of America, in collaboration with other Medicaid managed care organizations and state health plan associations.