Thursday, January 30, 2020

Following Trump admin's Medicaid initiative, Stitt announces 'SoonerCare 2.0'


Oklahoma City, Okla. (Jan. 30, 2020) – Governor Kevin Stitt today announced his administration’s healthcare plan, called SoonerCare 2.0, in Washington, D.C. where he was participating in the Trump administration’s release of the Healthy Adult Opportunity (HAO) initiative to give unprecedented flexibility to States to innovate and develop Medicaid plans for the adult population where federal funding is optional.

“I have sought Oklahomans’ input over the past several months in crafting my administration’s healthcare plan, and they have told me they want more access to care in rural Oklahoma, they want accountability and better outcomes in the current Medicaid system, and they want us to reclaim our tax dollars from Washington, D.C,” said Gov. Stitt. “With SoonerCare 2.0, we will achieve what Oklahomans are asking for, and we will fund it through efficiencies and accountability reforms, protecting Oklahomans from new taxes.

“With SoonerCare 2.0, we will pursue comprehensive reform of Medicaid delivery, made possible due to the unprecedented flexibility and innovation being granted by the Trump administration’s Healthy Adult Opportunity initiative. SoonerCare 2.0 will deliver strong personal-responsibility mechanisms for new enrollees, will target dollars on rural healthcare delivery and substance abuse programs, and transform services to be focused on outcomes and health advancements instead of excessive billing practices. In all things, we will pursue Top Ten status, and with SoonerCare 2.0 we will be taking a next step in pulling Oklahoma out of bottom ten healthcare rankings that our State has battled for generations.”

As part of SoonerCare 2.0, the Stitt administration will be pursuing the following:

Capture total federal funds available under Medicaid: In the coming few weeks, the State will submit a State Plan Amendment to the Centers for Medicare and Medicaid Services (CMS) coupled with applications for the new Healthy Adult Opportunity waivers to achieve maximum flexibility for use of more than $1.1 billion in additional federal Medicaid funds.

The State will need no new state taxpayer dollars to pay for its roughly $150 million share. The Stitt administration will seek partnership with the Legislature to support the State’s share by:

  • Recognizing cost savings in Department of Corrections and Department of Mental Health and Substance Abuse, where millions of dollars currently being paid 100% by the State will be replaced with federal funding once SoonerCare 2.0 is fully implemented.
  • Leveraging the full Supplemental Hospital Offset Payment Program (SHOPP) fee of 4% currently in state statue, a rate in Oklahoma that will remain below the national standard of 6%.
  • Requesting Oklahomans to reform TSET, protecting the corpus and leveraging future funds to directly deliver stronger, more accessible healthcare services to rural Oklahoma as part of SoonerCare 2.0.

Pursue maximum flexibility under the Trump administration’s Healthy Adult Opportunity to deliver personal responsibility: For Oklahomans that will become eligible for Medicaid under SoonerCare 2.0, the insurance program will be set up to create a true trampoline and prepare the individual to transition to employment and the responsibility of maintaining private insurance coverage. The Stitt administration will pursue HAO flexibility to implement modest premiums and establish work requirements that encourage individuals to be engaged in activity that advances their personal potential, such as education, certification, or employment.

Innovate the delivery of rural health care as well as specialized substance abuse programs with flexibility granted under the Trump administration’s Healthy Adult Opportunity: With HAO flexibility, SoonerCare 2.0 will innovate to improve access to care in rural Oklahoma. The Stitt administration will work with health care providers, communities and payers to act on new federal opportunities that will allow the State to enhance provider reimbursement, authorize telehealth services, manage non-emergency medical transportation, and redefine “hospitals” to expand care options in areas with limited populations. With HAO flexibility, SoonerCare 2.0 will also seek to expand targeted treatment for opioid addiction and substance abuse.

Deliver system reform across the full Medicaid program: To increase the effectiveness of Oklahoma’s Medicaid program and achieve better outcomes, the state will implement a full-risk managed care program with a strong quality component. Most states have abandoned years ago the government-run, fee-for-service program currently in place in Oklahoma. The Oklahoma Health Care Authority will go through a series of public bids and public comment periods to procure the right cost containment plan for Oklahoma.  The new Medicaid enrollees under SoonerCare 2.0 will be the first population under the reformed delivery system.

“The Oklahoma Health Care Authority is thrilled to be a part of Governor Stitt’s health plan, SoonerCare 2.0,” said Kevin Corbett, Director of the Oklahoma Health Care Authority. “Our agency, along with our partner agencies, stakeholders and in collaboration with the public, will pursue a rigorous and thorough process towards bringing this outcome based approach to managing our state’s health care needs and reaching the administration’s Top Ten goals.”

The agency will pursue the following priorities in obtaining and implementing this major reform initiative:

  • Transform primary care from a system that reacts after someone get sick to a system that keeps people as healthy as possible.
  • Pay for what works to improve and maintain health and convert volume-based fee-for-service payments into value-based payments that reward better health outcomes.
  • Prevent chronic disease whenever possible, and when it occurs, coordinate care to improve the quality of life and help minimize chronic care costs. 


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