Beginning in 2008, the Oklahoma Legislature passed Resolution 1058 in support of the patient-centered medical home (PCMH) and encouraged all health systems in Oklahoma to study and implement principles of the PCMH. Chapter 1656 of the Session Laws created a Medical Home Task Force charged with studying PCMH implementation among commercial and public payers. Oklahoma Health Care Authority implemented a PCMH primary care delivery system in January 2009 for SoonerCare Choice members. This model incorporated a managed care component with traditional fee-for-service and incentive payments for medical homes.
Launched as one of the 17 Beacon Programs funded by the federal Office of the National Coordinator (ONC) for Health Information Technology, MyHealth Access Network - a non-profit coalition of more than 200 organizations in northeastern Oklahoma - used innovative health care technology and dissemination of impactful information to enhance the capacity of medical homes to coordinate care and improve patient health. MyHealth seeks to achieve per-capita cost savings through improved care delivery for under-served populations. With an emphasis on access to specialty care and close regional disparities in health outcomes, MyHealth strives to show that diverse communities can achieve care that is high quality, affordable, efficient and results in healthier populations.
Oklahoma’s proposal for the State Demonstrations to Integrate Care for Dual Eligible Individuals includes multiple care coordination models for dual eligibles including:
Dual Eligible | 2703 SPA | CPC | CPC+ | PCMH QHP | PCMH Legislation | Private Payer |
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Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
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Oklahoma Comprehensive Primary Care Initiative | Multi-Payer | Tulsa Region | CMS Comprehensive Primary Care Initiative |
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Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
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CMS State Innovation Model (SIM) Design Award - Oklahoma | Grant | Statewide | CMS State Innovation Model (SIM) | |
INTEGRIS Health Medical Neighborhood Demonstration - Oklahoma | Grant | Oklahoma City | CMS Health Care Innovation Award - PCMN Demonstration |
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Oklahoma Health Home | Medicaid | Statewide | ACA Section 2703 Health Homes | |
SoonerCare Choice | Medicaid | Statewide | Medicaid Section 1115 Waiver |
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Legislation | Status | Year |
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Chapter 1656, Session Laws of Oklahoma The legislation created a Medical Home Task Force charged with studying PCMH implementation among commercial and public payers. |
Enacted | 2008 |
Resolution 1058 The legislation supported the patient-centered medical home (PCMH) and encouraged all health systems in Oklahoma to study and implement principles of the PCMH. |
Enacted | 2008 |
SB 1337 Requires Oklahoma state Medicaid managed care entitities to report on the percent of medical expenditures devoted to primary care. Requires managed care entities to increase primary care expenditures to a minimum of 11% of medical expenditures within four years. |
Enacted | 2022 |
SB 563 SB 563 affirmed requirements for reporting of the percentage of health care expenses by each contracted entity on primary care services and that no later than the fourth year of a contract with the Medicaid program must devote at least 11% to primary care. |
Enacted | 2023 |