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What’s up this week at Oklahoma Policy Institute? The Weekly Wonk shares our most recent publications and other resources to help you stay informed about Oklahoma. Numbers of the Day and Policy Notes are from our daily news briefing, In The Know. Click here to subscribe to In The Know.
This Week from OK Policy
OK Policy State Budget Summit, Advocate Training set for Jan 26 & 27: The Oklahoma Legislative session starts on Feb. 1, and setting the state budget is among the most impactful tasks lawmakers will tackle. To help Oklahomans better understand the state budget — and provide a look forward at the coming fiscal year — the Oklahoma Policy Institute is hosting its 7th State Budget Summit along with an advocacy training session. [OK Policy]
New GAO report details problems with managed care (Capitol Update): Recently Sen. Rob Standridge, R-Norman, issued a press release expressing his continued opposition to the Medicaid managed care proposal of Gov. Stitt. The Oklahoma Health Care Authority (OHCA) issued a Request for Proposal for insurance companies to bid on becoming a managed care organization (MCO), and contracts for three to five MCOs are expected to be awarded shortly before the legislature goes into session. However, legislation may be needed to fully implement the plan. [Steve Lewis / Capitol Update] OK Policy: Managed care is a bad investment for Oklahoma, but could be especially harmful for patients, providers, and Indigenous communities.
Policy Matters: Protecting, securing our state Capitol: The physical security of the Oklahoma Capitol seems to be at risk on two fronts – as part of a reported nationwide threat of armed protesters stirred by a months-long systematic misinformation campaign about the presidential election results, as well as the continued infiltration of the COVID-19 virus. Oklahoma’s leadership should take both threats seriously and address them via preventive measures. [Ahniwake Rose / OK Policy]
Weekly What’s That
Managed Care
Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Unlike a traditional fee-for-service system, in which a provider is paid directly by an insurer for every service delivered, under managed care, an organization or provider is responsible for providing a specified set of services for each insured member in return for a set monthly payment, known as the capitation rate.
A managed care organization is an entity that receives a capitated payment and coordinates a patient’s care through a defined network of physicians and hospitals. An HMO, or Health Maintenance Organization, is a variety of managed care organization that typically requires patients to seek care from doctors and other providers who work for or contract with the HMO. In exchange for being limited in their choice of providers, patients enrolled in an HMO typically have lower out-of-pocket costs than in a fee-for-service plan.
Oklahoma’s Medicaid program, known as SoonerCare, operates a limited form of managed care. Under the SoonerCare Choice program, most children and working-age adults select or are assigned to a Primary Care Provider/Care Manager (PCP/CM), who receives a monthly capitated payment for coordinating the care of each of their patients. Oklahoma ran a fully capitated managed care HMO program in urban areas from 1996 to 2004. In 2020, Governor Kevin Stitt and the Oklahoma Health Care Authority announced they were seeking proposals to again operate SoonerCare under capitated managed care to cover pregnant women, children, and low-income adults, including the population newly eligible under Medicaid expansion, with an implementation date of October 2021.
Look up more key terms to understand Oklahoma politics and government here.
Quote of the Week
“The governor says schools are safe, but what is he doing to ensure that? He calls for no quarantining when there is a mask policy but won’t demand strong mask policies. He cherry picks data instead of holistically tackling the pandemic.”
– Oklahoma Education Association President Alicia Priest [StateImpact Oklahoma]
Editorial of the Week
Governor’s guidance sets wrong goal
New guidelines announced this week by Gov. Kevin Stitt intended to promote in-person attendance at school during what we can only hope is the peak of a pandemic defy common sense.
Oklahomans are seeing more new COVID-19 cases today than ever before. More patients require hospital care — because many have no beds, they are being transported to locations outside the state — and double-digit death counts are being reported almost daily.
Still the governor continues to ignore science and promote an agenda that propelled Oklahoma into the Top 10 of practically every category a state should avoid during a public health crisis. Stitt said the policy change will allow districts to skip mandatory quarantine periods for teachers and students exposed to the novel coronavirus if mask mandates and social distance protocol are being followed.
“Schools that enforce the use of masks will not have to quarantine students that were potentially exposed to COVID-19 unless they are showing symptoms,” Stitt said this week during his public announcement. He chose to ignore the inconvenient fact that people exposed to asymptomatic carriers of the coronavirus are put at risk of becoming sick or dying.
Stitt, of course, can’t be faulted for wanting students to return to their classrooms. It is well established that most students learn better at school than they do in settings outside the classroom — the pandemic has been a hardship for a generation of students.
The inability to conduct in-person instruction for all students during the school year likely will be found to have been a drag on the economy. There is little doubt many parents have been unable to work at pre-pandemic levels because they now oversee their children’s virtual learning at home.
We fear pushing students back into classrooms on a whim — without ensuring the health and safety of educators, students and the families of both — would prove disastrous. This was proven last year as the governor ignored science and rejected guidance and recommendations offered by both the Oklahoma State Health Department and White House Coronavirus Task Force.
Stitt and his advisers said the new guidance is aimed at keeping students and staff in the classroom. To keep this pandemic from becoming a plague, the goal of any guidance should be to curb the spread of a coronavirus that has sickened and killed so many and ease the burden present policies placed on our health care professionals.
Numbers of the Day
- 6,487 – Number of new COVID-19 cases reported on Sunday, which is a record. The latest report brings Oklahoma’s seven-day average to 3,899, which also is the highest the state has ever seen.
- 412 to 1 – Oklahoma public schools’ student to counselor ratio. The recommended student to counselor ratio is 250 to one.
- 3.5x – The cumulative incidence of laboratory-confirmed COVID-19 cases among American Indians and Alaska Natives was 3.5 times higher than for whites.
- 32.6% – Percentage of Oklahomans whose blood was tested Jan. 1-7 and were positive for the virus’ antibodies.
- 46% – Oklahoma’s percentage increase of COVID-19 patients in acute-care hospitals between Nov. 12 and Jan. 11.
See previous Numbers of the Day and sources here.
What We’re Reading
- Beyond Politics — Promoting Covid-19 Vaccination in the United States [New England Journal of Medicine]
- Jobs recovery stalled in December, highlighting importance of further relief and stimulus measures [Center on Budget and Policy Priorities]
- Tribal Elders Are Dying From the Pandemic, Causing a Cultural Crisis for American Indians [New York Times]
- A year ago, women outnumbered men in the U.S. workforce, now they account for 100% of jobs lost in December [CNBC]
- Value-Based Care Isn’t Transforming Health Care Spending (podcast) [Health Affairs]
