UPDATE: OHCA officials said Wednesday morning (Jan. 20) that this meeting will be rescheduled following a decision by the board chair.
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The Oklahoma Health Care Authority is continuing to stifle taxpayers who want to comment on a major change in its health care system. The Board of the Oklahoma Health Care Authority (OHCA) is meeting on January 20 at 3:00 p.m., where it will vote whether to fund SoonerSelect, the state’s proposed privatized Medicaid managed care plan. Due to the expiration of 2020’s emergency measures allowing virtual public meetings, only in-person comments will be accepted during Wednesday’s public meeting.
Oklahoma remains among the worst states for COVID-19 test positivity rates with virus-related hospitalizations continuing as a significant strain on our health care systems. As a result, public meetings can turn into potential health hazards. OK Policy is calling on the OHCA to postpone this vote until members of the public can comment without risking their health. Otherwise, the OHCA will force health care advocates to make the unconscionable choice between risking their health to physically attend a public meeting or being silenced about major policy changes.
During the summer, OHCA and Gov. Stitt announced it would seek proposals from companies to provide managed care, which would transition coordination of medical services from OHCA to a private, third-party vendor. Oklahoma has tried this approach in the past, and it was ultimately shelved due to its high costs.
The OHCA’s own Medical Advisory Committee voted to condemn the agency’s efforts to transition the state’s Medicaid program to managed care this fall, and the CoverOK coalition of health care providers and Oklahoma non-profit organizations this fall called on OHCA to ensure that the state’s health care system best serves the needs of Oklahomans. Among its recommendations was “to provide clear communication and ample time for community members and stakeholders to weigh in for comment and feedback.”
OK Policy officials said the latest restrictions are consistent with OHCA’s continued pattern of shutting out Oklahomans from providing input or comment on its efforts to implement managed care for SoonerCare, the state’s Medicaid program. In November, OK Policy raised concerns that the public was not given due opportunity to speak out against the move.
Statement from OK Policy’s Executive Director Ahniwake Rose:
“Moving SoonerCare to a managed care system is a major taxpayer expenditure, and it is deeply troubling that OHCA is not providing opportunity for Oklahomans to have either public comment or open discussion about this significant change. It’s antithetical to proper management of the people’s business when the public is actively denied opportunity to provide input in how their tax dollars are spent.”
Rose said that OK Policy would not potentially endanger the health of its staff to attend the meeting in person. Until lawmakers revisit measures for virtual public meetings or OHCA expands opportunities for public comment, there are few opportunities to voice concern or comment to the public record.
This is the statement OK Policy would have shared during Wednesday’s meeting:
The Oklahoma Policy Institute wishes to go on record to raise concerns about the potential transition from traditional SoonerCare to privatized managed care. Making this change will likely cost the state money, will harm providers (particularly in rural areas), and will limit access to care for many Oklahomans who use Medicaid to see a doctor.
Oklahoma has tried to implement managed care in the past, but ultimately found that SoonerCare would be more cost-effective if administered directly by the OHCA. In fact, a national study found that the OHCA had constructed a Medicaid program that fit Oklahoma well, and that “with sufficient resources and leadership commitment, state Medicaid agencies can manage care at lower costs than managed care organizations (MCOs) and with similar outcomes.
Moving to privatized managed care – particularly on a compressed timeline, without substantial public input – risks significantly disrupting patient care and provider solvency, as OHCA’s own documents show. While OHCA officials have said that provider rates will remain stable during and after the transition, the Bidder’s Conference showed something else. While reimbursement rates may remain the same, the actuaries recommended an immediate 40 percent decrease in inpatient hospital utilization and a 20 percent reduction in behavioral health utilization.
When Medicaid expansion goes into effect on July 1, there will likely be significant need for mental and behavioral health services, since most new enrollees won’t have been previously insured.Justifying this privatization by claiming that current provider rates will be maintained without acknowledging the loophole that will result in lower provider payments is deceitful. This decrease will harm providers, particularly those in rural areas and those with a large Medicaid patient population, who rely on the consistency of Medicaid payments to keep their doors open.
These reductions will also harm Oklahoma patients, who may be denied services in order to maintain utilization rates and costs. If providers are forced to close or stop accepting Medicaid patients as a result of smaller payments, patients will lose access to primary and speciality care. This will particularly impact rural Oklahomans and could lead to inadequate networks or put long distances between patients and their doctors.
No peer-reviewed studies have found evidence of state savings as a result of privatization, and there are no definitive conclusions on the actual impact of privatized managed care on patient health outcomes. In the absence of actual evidence, and in the face of so many potential negative outcomes, the OHCA Board should not vote to fund this privatized managed care model. Instead, the Board should take steps to protect and strengthen the current in-house administration of Medicaid that has been nationally recognized for its effectiveness.