Oklahoma Health Care Authority outlines April 1 launch, provider protections and payment rules for Sooner Select

Ellen Bittner, chief executive officer of the Oklahoma Health Care Authority, opened a provider briefing on the agency's transition to Sooner Select, the state's new managed-care delivery model, and introduced the plans selected to serve SoonerCare members.

The agency said three medical plans'Aetna Better Health, Humana Healthy Horizons and Oklahoma Complete Health'and two dental plans'DentiQuest and Liberty Dental'will participate. Oklahoma Complete Health will operate a single statewide children's specialty plan for children in the custody of child welfare and juvenile-justice services; those children will be automatically enrolled, officials said.

Traylor, an Oklahoma Health Care Authority presenter, said the transition aims to shift payment toward value-based models, improve member satisfaction and contain costs through care coordination. "We always pay on time," Traylor said, noting contracts include a maximum turnaround of 14 days from claim submission and that many plans expect to pay in seven days or less.

To drive outcomes, the authority said contracts contain specific quality metrics, time frames and both incentives and penalties over a five-year period. Contract language requires contracted entities to spend 11% of medical spend on primary…