The Oklahoma Health Care Authority (OHCA) held a significant town hall meeting in Enid on February 1, 2024, to discuss the upcoming changes to the SoonerSelect program, which is set to launch on April 1, 2024. This initiative aims to streamline healthcare services for Oklahomans while addressing concerns raised by healthcare providers regarding administrative burdens and reimbursement rates.

One of the key highlights from the meeting was the commitment to maintain a centralized billing process for providers. With the addition of three new medical and two dental contracted entities, there were concerns about the complexity of billing and prior authorization processes. However, OHCA representatives assured providers that a single provider portal would be implemented, simplifying these tasks and reducing administrative strain.

Another critical topic was the introduction of rate floors for providers, which will remain in effect until July 1, 2026. This measure aims to alleviate fears that managed care entities might reduce reimbursement rates. The OHCA emphasized that while there will be profit margins for private managed care, these should not come at the expense of providers. The goal is to transition to value-based payment methodologies gradually, ensuring that providers are supported during this shift.

The meeting also clarified which populations would be covered under the SoonerSelect program. Most Oklahomans, excluding those who are aged, blind, or disabled, will be included, with specific provisions for children in the custody of child welfare and juvenile justice services. This broad coverage is designed to enhance access to healthcare services across the state.

In addition to standard healthcare services, the OHCA plans to introduce value-added benefits that address social determinants of health, which are currently not covered under the existing fee-for-service model. This flexibility will allow contracted entities to offer additional services that can significantly impact overall health outcomes for members.

The OHCA is also establishing a quality advisory committee to oversee the implementation of these changes, ensuring that local providers have a voice in shaping the future of healthcare in Oklahoma. This committee will meet regularly and will be open to public participation, fostering transparency and community involvement.

As the launch date approaches, the OHCA is focused on ensuring that both providers and members are well-informed about the changes. Trained member services staff will be available to assist families in navigating their options and understanding the differences between various plans.

In conclusion, the town hall meeting underscored the OHCA's commitment to improving healthcare delivery in Oklahoma while addressing the concerns of providers. The upcoming changes to the SoonerSelect program are poised to enhance access to care, streamline administrative processes, and ultimately improve health outcomes for Oklahomans.