Oklahoma Announces Contracts for Medicaid Managed Care Program

Oklahoma has officially chosen four Medicaid contracts for its Medicaid managed care program known as SoonerSelect, according to state healthcare officials.

The state chose Centene, UnitedHealthcare, Humana, and Blue Cross and Blue Shield of Oklahoma (BCBSOK). Officials projected that the move towards Medicaid managed care would boost the economy, with an estimated 1,500 new jobs to result.

Centene highlighted its aptness for this role due to the company’s experience as a leading payer in the space of foster care services.

That experience will be relevant as the contracted payers will be responsible for Oklahoma’s SoonerSelect Specialty Children's plan. This plan attends to the physical, behavioral, and mental health needs of children in Oklahoma’s juvenile justice system and reliant on the Department of Human Services.

“We look forward to working with the state of Oklahoma in their transition to value-based care models by providing services that address the social determinants of health, remove barriers to treatment, and deliver better health outcomes for Oklahoma residents at a lower cost to the state," said Brent Layton, executive vice president of markets, products, international, and chief business development officer of Centene.

More than one of the selected payers had been in the state for decades.

“UnitedHealthcare has been committed to improving the health and well-being of Oklahomans since 1985, and we look forward to serving SoonerCare beneficiaries by providing high quality, sustainable health care,” Megan Haddock, chief executive officer of UnitedHealthcare Community Plan of Oklahoma, said in a press release.

“We are honored to continue our partnership with the state to help Oklahomans live healthier lives.”

UnitedHealthcare stated that beneficiaries will have access to preventive care, primary care, hospitalization, and other key services at little to no cost.

UnitedHealthcare serves almost 600,000 Oklahoma residents in individual health insurance plans, Medicare, employer-sponsored health plans, and dual special needs plans. Additionally, the payer pointed out that it employs almost 1,000 Oklahomans.

Humana currently covers over 270,000 Oklahomans in total, including Medicare Advantage and TRICARE beneficiaries. That number will change when it begins to accept Medicaid beneficiaries as part of its contract with the state.

“Humana is honored to have been chosen to serve Oklahomans covered under the state’s new Medicaid managed care program,” said Humana Medicaid President John Barger.

“We look forward to partnering with the state to bring forward an individualized approach to care that considers the physical and mental well-being of beneficiaries, as well as the critical social determinants that impact the population. We’re proud to have served Oklahoma communities for more than three decades, and we share with the Oklahoma Health Care Authority a deep commitment to delivering quality health care services to Oklahomans who need it most.”

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is the oldest and largest member-owned health insurer in the state, having served the state since 1940, the payer reminded in its press release. The payer mentioned that it will be leveraging coordinated care to improve patient outcomes for Medicaid beneficiaries.

“We believe this is the right thing to do for our members, our company and Oklahoma’s future,” said Joseph R. Cunningham, MD, president of BCBSOK. “We look forward to serving the SoonerSelect population and helping to improve health outcomes through coordination of services, while advancing the state’s efforts toward payment and delivery system reform.”

The move towards managed care was a controversial one in Oklahoma, as have been many other Medicaid-related decisions that the state made in the past year.

In April 2020, Oklahoma submitted a Healthy Adult Opportunity waiver to receive the equivalent of a block grant. It was the first state to officially do so.

Then only three months later, Oklahoma became the first state to adopt Medicaid expansion during the coronavirus pandemic. This move was motivated by a statewide ballot that altered the state’s constitution.

Before the state decided to expand its Medicaid program, experts from the left-leaning think tank Center on Budget and Policy Priorities predicted that 263,000 Oklahomans would gain access to Medicaid, including 22,000 essential workers. The expansion is expected to  cost around $150 million per year.