OICA to Monitor Medicaid Managed Care to Ensure it Works for Kids

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I have written about Oklahoma’s Medicaid program, SoonerCare, and its importance in providing needed healthcare for Oklahoma’s most vulnerable children.

As of May 2020, there were 833,302 Oklahomans enrolled in SoonerCare, and more than 550,000 of them are children. Over half a million Oklahoma children are dependent on SoonerCare for their medical, vision, hearing, and dental checkups to help them stay healthy. We adults owe it to these children to ensure they receive the best care available, and the insurance to cover it.

On June 18, 2020, Governor Kevin Stitt and Oklahoma Health Care Authority (OHCA) CEO Kevin Corbett announced the state would seek proposals from qualified managed care organizations (MCOs) to improve health outcomes, increase access to care, and increase system accountability SoonerCare.

This month, the Oklahoma Health Care Authority will adopt two proposals, one to shift to a managed care system for their health insurance and another for their dental services for those who qualify for Medicaid. We at OICA are encouraged by the possibility to improve health outcomes for children through public/private partnership.

Oklahoma ranks sixth in the nation in childhood obesity, fifth in teen birth rates, and tenth in teen suicides. Under managed care plans, the goal is for children and their parents/ guardians to get more individualized care plans, assistance coordinating their care, and better access and improved overall health outcomes.

Managed care organizations focus on preventative care to take care of issues or concerns before they spiral out of control, things such as yearly checkups, immunizations, and preventative screening. MCOs work collaboratively with doctors, hospitals, and specialists to ensure better health outcomes for children, which lowers costs and reduces hospital visits before issues grow worse. Consistent care also minimizes interruptions in coverage, duplicative appointments, and costly medical tests.

Managed care can be especially helpful for the 28.5% of children who are in foster care, have unstable home lives or who have experienced trauma. These children face many obstacles in receiving consistent health care due to frequent moves, changes in guardians, and navigating tough emotional and mental health challenges. The Annie E. Casey Foundation found that nearly two-thirds of children entering foster care have behavioral or emotional problems.

Children experiencing adverse situations need the continuity of care that managed care plans can provide to ensure doctors and specialists remain covered and in the loop about a child's move or development. This simple step could be the lifeline a child needs to have better overall health in the future.

Of course, with increased privatization, transparency and accountability must be in place to ensure optimal delivery of services is provided. I have confidence OHCA will provide this, but OICA will continue to be the watchdog for children and monitor programs to verify best practices are in place.

The COVID-19 pandemic has caused many Oklahomans to lose their jobs and insurance coverage, placing increased demand and need for a Medicaid system that works well for families and keeps their health as a priority. Medicaid managed care has the potential to make this increased demand and the upcoming expansion successful and ultimately create better health outcomes for our state.

About OICA: The Oklahoma Institute for Child Advocacy was established in 1983 by a group of citizens seeking to create a strong advocacy network that would provide a voice for the needs of children and youth in Oklahoma, particularly those in the state’s care and those growing up amid poverty, violence, abuse and neglect, disparities, or other situations that put their lives and future at risk. Our mission statement: “Creating awareness, taking action and changing policy to improve the health, safety, and well-being of Oklahoma’s children.”