• OAHP

Oklahoman: Changing Oklahoma outcomes starts with more health plan choices for women, children

Viewpoint: Changing Oklahoma outcomes starts with more health plan choices for women, children

Haley Faulkenberry, Executive Director of Oklahoma Association of Health Plans

If Oklahoma is ready to make rapid advancements in pulling itself out of last place in health outcomes, it starts with how we care for our children.

Oklahoma is ranked #44 in the nation in health outcomes for children, according to the 2021 America’s Health Rankings published by United Health Foundation. These numbers are impacted by poor participation rates of developmental screenings and well-child visits as well as poor rankings in food sufficiency and with depression.

More than half of Oklahoma’s children, and growing, also receive their healthcare through the State’s Medicaid program - SoonerCare.

It couldn’t be clearer: by looking to reform and modernize Medicaid, we can immediately move the needle and build a brighter future for the next generation of Oklahomans.

Oklahoma is one of the last states left implementing Medicaid as it was designed in 1965 as a fee-for-service, government-controlled insurance program. More than 40 other states have closed the chapter on this outdated method.

Instead, these 40 other states have entered public-private partnerships focused on incentivizing better outcomes and the latest healthcare practices. These structures, implemented by managed care providers, give more health plan choices to Medicaid consumers, incentivize innovation in the private sector to care for the whole person, and streamline a patient’s critical health records across a large network.

A recent article by an Oklahoma outlet reported that SoonerCare pays for more than 57 percent of the births in the state, yet we also have one of the highest infant mortality rates and the fourth-highest rate of maternal mortality. This is unacceptable.

Managed care organizations can be part of the solution because they have the flexibility to cover maternal health as well as labor and delivery services that are not currently covered by the State.

For example, SoonerCare doesn’t cover doula services, hospital grade breast pumps, vouchers for prenatal education and the transportation to get to these critical educational courses, or reimbursement for faith-based support that improves a mother’s behavioral or physical health. Managed care plans in other states include these types of services for their Medicaid enrollees, leading to better outcomes.

Better outcomes during pregnancy and at birth mean less impact on the healthcare system long term.

Managed care partnerships do not stop there. In a statewide system, a third-party Medicaid provider will help ensure that a child born to a single mom will also have consistent, uninterrupted care when needing to transfer from a family pediatrician in Lawton to a specialized doctor in Oklahoma City for addressing a unique diagnosis.

This unique diagnosis would be discovered early, because the managed care provider created incentives for the family to participate in regular developmental screenings - a service Oklahoma is poorly ranked in today.

It’s time to say goodbye to 1965. Oklahomans deserve better Medicaid, and we have the gift of looking at 40 other states to adopt best practices for delivering a program that is a true springboard propelling people with life-changing healthcare.

The sooner we can focus the system on better outcomes, the sooner we can build Oklahoma’s future for a healthier society.