The Oklahoma Health Care Authority submitted a waiver to the Centers for Medicare & Medicaid Services to transition from a feefor- service system to the new comprehensive health delivery system, SoonerSelect. The 1915(b) waiver begins the process of working collaboratively with CMS on the transition to SoonerSelect.
The agency will begin working with the contracted entities and CMS to ensure all parties are ready for a smooth transition. This includes making sure all systems are tested and operating correctly and the OHCA team is ready to monitor and provide oversight.
“This milestone brings us one step closer to enhancing the quality- of-service Sooner-Care members receive,” said OHCA CEO Kevin Corbett. “OHCA will be working diligently with our CMS partners to make sure we are ready to transition into the oversight role while maintaining our commitment to improving the health and lives of Oklahomans.”
SoonerSelect will allow OHCA to better incentivize health outcomes while maintaining oversight and authority over Oklahoma’s Medicaid program and the program’s funding. The agency is committed to improving the health and lives of SoonerCare members and will hold its SoonerSelect partners to high standards through strong accountability measures.
OHCA expects to launch the dental plans with the two qualified dental contracted entities, DentaQuest and LIBERTY Dental, in Feb. 2024.
The dental contracted entities will implement comprehensive care coordination strategies for members, which will redirect members from using emergency department services, increase preventive care and reduce the need for high-cost restorative procedures, and improve provider and specialist networks.
The medical and children’s specialty plans for SoonerSelect are expected to launch in April 2024.The contracted entities serving the medical plans are Aetna Better Health of Oklahoma, Humana Healthy Horizons of Oklahoma and Oklahoma Complete Health, a subsidiary of Centene Corporation. The selected contracted entity serving the children’s specialty program is Oklahoma Complete Health.
“Pursuing the 1915(b) federal authority option puts us on the right trajectory to achieving CMS approval for the two SoonerSelect implementation dates in early 2024”, said Traylor Rains, State Medicaid Director. “By launching the dental plans first, we are able to maximize our resources by focusing on readiness processes separately for dental and medical plans ensuring the highest quality product upon implementation.”
SoonerSelect will allow OHCA to enhance the quality-of-service SoonerCare members receive by leveraging the resources of the contracted entities and investing in enhanced care coordination and social determination of health, leading to improved health outcomes for Oklahomans.
All health plans will be required to provide SoonerSelect members the same health care services currently offered by SoonerCare but may offer additional benefits to help improve the health of our members.
For more information and updates about delivery reform in Oklahoma, visit https://oklahoma. gov/ohca/about/delivery- reform.html.
