State Contracted Consultant Releases Recommendations to Cover the Uninsured

In a meeting of the OHCA Board of Directors, Thursday, Leavitt Partners presented highlights of their long-awaited recommendations for expanding coverage outside of the ACA-provided Medicaid eligibility expansion.  These included using Insure Oklahoma modifications as a basis for alternative coverage.  The group also indicated that, overall, Oklahoma Medicaid is ran well, and the agency should continue pursuing improvements already in the works.  

Overall, the firm recommended reducing Medicaid eligibility for certain groups that are eligible for tax credits in plans through a Federally-facilitated Health Insurance Exchange, and leveraging 100% Federal matching for I/T/U services.  Further, OHCA would pursue a Medicaid waiver from CMS to use a modified version of the Insure Oklahoma Individual Plan to provide an alternative coverage option.  Modifications may include providing wrap around services for the disabled and medically frail including care coordination.  Provider and patient behaviors would be incentivized through payment changes. Patients might have reduced or waived copayments for obtaining preventive services, for example.  The group estimates that changes could result in a net economic gain to the state of over $400M.   

An OHCA board member expressed readiness to pursue actions from these recommendations.  The Governor had previously indicated intentions to use the Leavitt Partners recommendations in formulating an Oklahoma Plan.

The presenters recommended a steering committee be formed quickly and that recommended changes may take place in 2015. Report documents are available online.

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