Name: Despite opposition, Health Care Authority moves forward with $2B plan to privatize Medicaid
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Despite opposition, Health Care Authority moves forward with $2B plan to privatize Medicaid

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Carmen Forman A split Oklahoma Health Care Authority board on Tuesday signed off on plans for the agency to spend up to $2.2 billion to privatize the state’s Medicaid program.After a lengthy debate where efforts to table the controversial agenda items failed, the board did not approve specific contracts with for-profit companies to manage the program’s spending, but gave the agency approval to move forward with overhauling Medicaid., the Health Care Authority is seeking to contract with outside entities to manage medical care for roughly 700,000 of Oklahoma’s Medicaid recipients through what is often referred to as a managed-care model.“Engaging providers through a managed care organization will help us achieve our goal of ensuring Oklahomans receive improved access and quality care,” Stitt previously said in a statement.Managed care is an approach to health insurance coverage that seeks to maximize health care quality while stabilizing or cutting costs. Opponents of managed care argue that health care cannot be improved when costs are cut.The board’s decision sets up a potential fight between Stitt and the Oklahoma Legislature, where a bipartisan group of lawmakers oppose implementing managed care. At least 33 Republican members of the Legislature and many in the Democratic minority oppose privatizing Medicaid.In a legislative budget hearing Tuesday, Rep. Marcus McEntire, R-Duncan, accused Health Care Authority CEO Kevin Corbett of rushing through the contracts so the process is complete before the Legislature returns Feb. 1.Corbett defended the agency's actions, saying the switch to managed care is a massive undertaking that will take time to ramp up to the launch date of Oct. 1."We started this back in June, so to us, it's not rushed," Corbett said. "It's part of the execution plan we set forth."McEntire, who said he felt like the Legislature has been excluded from the process thus far, encouraged Corbett and the governor's office to include legislators in future managed care discussions.Representatives from five major Oklahoma health care associations begged members of the Health Care Authority board to oppose funding for managed care contracts.Although much research has been done on managed care, there are no definitive conclusions that hiring for-profit companies to manage care improves health outcomes for patients, said Debra Billingsley, executive director of the Oklahoma Pharmacists Association."In order to have better outcomes, we need to not throw money at the problem, but help our patients be more informed decision makers about their own health," she said.In a statement, the Hospital Association said it was disappointed with the board’s decision to approve funding for managed care.Sandra Harrison, the group's vice president of regulatory and legal affairs, expressed concerns that an actuarial analysis from the agency estimated inpatient care would be reduced by 40% and behavioral health will be reduced by 20% within the first year under managed care.“Privatizing our state’s Medicaid system will lead to reduced access for our most vulnerable Oklahomans and will only cost the state and taxpayers more,” the group said.This is the Health Care Authority's chance to improve the state from 46th in the nation in health outcomes, Corbett said."I hope (lawmakers) understood our position and our efforts to do something that’s really transformational for the state," he said., seven companies submitted bids to manage medical treatment and three companies offered to manage dental treatment for most of the state's Medicaid recipients.The chosen companies could be announced as soon as this week, Corbett said."We have great confidence in who we do business with, otherwise we won’t do business with them," he said.Health Care Authority Board member Tanya Case, who opposed the managed care measures, questioned why members of the board were being asked to vote on managed care funding when there is no guarantee the Legislature will appropriate the funding.The Legislature controls funding for state agencies, and the managed care contracts can only be carried out if the Legislature appropriates funding for the contracts.Questioning why lawmakers seemed to be left out of the decision-making process, Case unsuccessfully pushed to table the managed care questions in the hopes the board could vote on the measures after the topic came before the Legislature.“It needs to be a joint decision between the Legislature and the governor,” she said. “It has not been a joint decision between the Legislature and the governor. It’s a unilateral decision by the governor. There are many, many legislators that are very opposed to going forward with a for-profit managed care methodology.”On July 1, Oklahoma will expand Medicaid to cover more low-income residents, at which point, the agency will oversee care for an estimated 1.2 million Oklahomans.The Health Care Authority board approved the following measures Tuesday on divided votes:• Allowing the agency to contract with multiple companies to manage medical care for most of the state’s Medicaid recipients at a cost of no more than $2.1 billion spent between July 1, 2021- June 30, 2022• Allowing the agency to hire companies to manage dental care for some Medicaid recipients at a cost of up to $110 million in the upcoming fiscal year.Reporter Carmen Forman covers state government, politics and the COVID-19 pandemic for The Oklahoman. Send story tips to cforman@oklahoman.com or connect on Twitter with @CarmenMForman. 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Carmen Forman A split Oklahoma Health Care Authority board on Tuesday signed off on plans for the agency to spend up to $2.2 billion to privatize the state’s Medicaid program.After a lengthy debate where efforts to table the controversial agenda items failed, the board did not approve specific contracts with for-profit companies to manage the program’s spending, but gave the agency approval to move forward with overhauling Medicaid., the Health Care Authority is seeking to contract with outside entities to manage medical care for roughly 700,000 of Oklahoma’s Medicaid recipients through...

Despite opposition, Health Care Authority moves forward with $2B plan to privatize Medicaid

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