Oklahoma Health Care Authority Releases RFP for SoonerSelect Medical and Pediatric Specialty Plan – Okemah News Leader

Oklahoma City, OK – The Oklahoma Health Care Authority invites proposals to implement a comprehensive medical delivery system for the agency’s new health care model, EarlierSelectfollowing Governor Kevin Stitt’s signing of two delivery system reform bills.

EarlierSelect will allow OHCA to better incentivize health outcomes while maintaining oversight and authority over Oklahoma’s Medicaid program and program funding. The agency is committed to improving the health and lives of EarlierCaremembers and will hold its EarlierSelect partners to high standards through strong accountability measures.

“OHCA is required to select at least three contracted entities for medical services and one contracted entity for the children’s specialty plan. Contracted entities can include accountable care organizations, provider-led entities, and business plans,” said Kevin Corbett, OHCA CEO and Secretary of Health and Mental Health.

This partnership will allow the OHCA to improve the quality of service EarlierCare that members receive by leveraging contracted entity resources and investing in better care coordination and social determination of health, leading to better health outcomes for Oklahomans.

All health plans will be required to provide EarlierSelect members the same health care services currently offered byEarlierCare but may offer additional benefits to help improve the health of its members.

“We have high expectations for contracted entities, such as achieving specific quality metrics and developing strategies to address health disparities and social determinants of health,” said the director of State Medicaid, Traylor Rains. “I look forward to seeing how these organizations will help further our mission and improve health outcomes for Oklahomans.”

The transition in health care delivery will enable the agency to achieve the following payment and delivery system reform objectives:

  • Improving Health Outcomes for Oklahomans
  • Switch to value-based payment
  • To improve EarlierCare member satisfaction
  • Control costs by investing in preventive and primary care
  • Increase the predictability of costs for the State

Oklahoma joins 40 other states in hiring third-party organizations to administer certain Medicaid benefits. States reported positive results, such as cost containment by investing in primary care, prevention services and effective quality improvement strategies. It is common for these contract organizations to invest heavily in infrastructure, including technology, staffing, and research into best practices to coordinate member care. Selected organizations will be required to have a presence in Oklahoma, including key personnel and call center operations.

“Working alongside these highly qualified contracted entities is the first step in strengthening our ability to serve Oklahomans,” Corbett said.

The bidding process will close on February 8, 2023. Contracts will be awarded and announced early next year.

For more information and updates on delivery reform in Oklahoma, visit https://oklahoma.gov/ohca/about/delivery-reform.html.

To view the medical request for proposals, visit https://oklahoma.gov/omes/services/purchasing/solicitations/8070000052.html.

To view the solicitation for the children’s specialty plan, visit https://oklahoma.gov/omes/services/purchasing/solicitations/8070000053.html.

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