Care Coordination Models for Aged, Blind and Disabled Persons  

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Pursuant to House Bill 1566 passed by the Oklahoma Legislature and signed by Gov. Mary Fallin in April 2015, the OHCA will issue a Request For Proposal (RFP) for a care coordination model for the Aged, Blind and Disabled (ABD) populations. To comply with the new state regulation, the OHCA has and continue to solicit information and input from a wide variety of stakeholders including but not limited to members, advocates, providers, health care systems, and the general public. Through a Request For Information (RFI) process in June of 2015, for the development and requirements of the RFP. 

The OHCA released a Request For Information (RFI) in June of 2015 and made it available for general input, comments and responses from interested stakeholders on its public website at http://www.okhca.org/about.aspx?id=3243. The RFI sought information on care coordination models that would be used for the development and requirements of the RFP.

Additionally, the OHCA has and continues to hold public stakeholder meetings and regional focus groups to gather input from a variety of stakeholder groups. The information gathered was reviewed and analyzed to develop the framework for the selection of a care coordination model. The model was announced on Nov. 30, 2015.

The OHCA is now developing an RFP for a fully capitated model of care coordination for SoonerCare ABD members. An initial draft is anticipated to be available in the spring, with final release in the summer of 2016.

The OHCA continues to gather contact information for stakeholders interested in being a part of the discussions. All interested parties are encouraged to provide their contact information including especially an email address, to receive periodic updates as well as notifications of future stakeholder meetings.

If you are a stakeholder wanting to stay informed click here to submit your contact information.

Please send your comments and concerns to OHCA at ABD@okhca.org. All potential bidders and their consultants are reminded to hold all questions for submission to OHCA Contracts Coordinator only during the Question and Answer period of the RFP.


Issue Statement

February 10, 2016

OHCA Contacts: Jo Kilgore - (405) 522-7474,  Jennie Melendez- (405) 522-7404   

ABD RFP development delay

The Oklahoma Health Care Authority (OHCA) will resume ABD stakeholder meetings in May as part of the Request for Proposal (RFP) development for the ABD Care Coordination program. The two-month delay in the timeline is due, in part, to the need for additional time for the actuary to develop rates. The development of actuarial rates is a critical component of the RFP development. The first deliverable from the actuary is due in May of 2016. 

Also, as OHCA staff began to delve into the details of the RFP development, additional sections were identified as needed. This has also increased the amount of work and time needed for the project. 

Due to the extended timeline of the RFP development, the quiet period required by state of Oklahoma procurement law is also extended. Therefore, the OHCA is cancelling the March and April stakeholder meetings.

An updated timeline for the project is available below.






News Release

November 30, 2015

OHCA Contacts: Jo Kilgore - (405) 522-7474,  Jennie Melendez- (405) 522-7404   

Agency selects care coordination model for Aged, Blind and Disabled populations

OKLAHOMA CITY – Following five months of intensive planning, leaders of the Oklahoma Health Care Authority (OHCA) announced they will develop a Request for Proposals (RFP) aimed at contracting for a fully capitated, statewide model of care coordination for Oklahoma Medicaid’s Aged, Blind and Disabled (ABD) populations.

The RFP is the result of HB1566, passed during the 2015 Oklahoma Legislative session. The bill charged OHCA with issuing an RFP for care coordination models for its ABD populations. The intent of the legislation is to provide better access to care, improve quality and health outcomes and control costs.

"Oklahomans with complex medical needs can benefit greatly from a care coordination model that gives them one effective team whose job is to help them navigate the medical world of doctors and specialists in every field. One effective team that helps them make their appointments, get their medicine, and get them on the road to better health. One effective team who helps them receive needed specialized services that could prevent a hospital stay. Our goal is a healthier Oklahoma!"‎ said state Sen. Kim David, R-Porter, co-author of the measure and chair of the Senate Appropriations Subcommittee on Health and Human Services.

“The goal behind House Bill 1566 is to improve health outcomes for the aged, blind and disabled while maximizing limited resources,” said state Rep. Glen Mulready, R-Tulsa, co-author of the measure and chair of the House Insurance Committee. “We believe we can provide better quality healthcare at a lower cost for this particular population of Oklahomans by introducing competition into the system. We have just completed a very extensive review process that included hundreds of providers and participants. I am very pleased that we have reached this point in the process, and I am excited to work with the Health Care Authority as we move forward.”

OHCA solicited input on potential care coordination models from a wide variety of stakeholders. Over a three-month period, OHCA and its consultant, Pacific Health Policy Group (PHPG), held meetings with ABD members, their families, providers, advocates and other stakeholders throughout Oklahoma. OHCA also gathered recommendations through a Request for Information (RFI) that drew responses from 22 Oklahoma-based and national health care organizations interested in serving ABD members. 

After careful review and analysis of the information received through the various venues for stakeholder engagement, and through responses to the RFI, the OHCA has chosen a fully capitated, statewide model of care coordination. OHCA believes this model will meet the intent of the legislation by providing the highest quality of care for the ABD populations, while helping to control costs and improve health outcomes. RFP development will begin in December with an anticipated release date of June 2016.

More information about the process is available on this page.

The Oklahoma Health Care Authority (OHCA) administers two key health programs for the state. The first is SoonerCare, Oklahoma’s Medicaid program. SoonerCare works to improve the health outcomes of Oklahomans by ensuring that medically necessary benefits and services are responsive to the health care needs of our members. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. OHCA strives to educate and engage our current 827,118 members regarding personal responsibilities for their health services utilization, behaviors, and outcomes in partnership with a state-wide network of 44,288 providers. For more information, visit www.okhca.org or www.insureoklahoma.org.


To view a fact sheet on the ABD Care Coordination model, click here.


Frequently Asked Questions: Click here to view FAQs on the development of the ABD Care Coordination Models.


Archived Information: Click here to view previous ABD Care Coordination information.

Proposed Timeline:

In order to comply with Oklahoma State Procurement law, OHCA will be entering into a quiet period during the development of the ABD Care Coordination RFP.  As a result, the December and January ABD Care Coordination Stakeholder meetings have been cancelled.  We anticipate resuming the monthly stakeholder meetings in March 2016.  All potential bidders are asked to hold all questions for submission to the OHCA Contracts Coordinator only during the Question and Answer period of the RFP.


ABD Care Coordination 2016 Timeline for Public Website

 (All Dates Are Tentative And Subject To Change)

   

February 2016

  • RFP Development Continues

March 2016

  • RFP Development Continues
  • Stakeholder Meeting-Tuesday, March 8, 2016 - Canceled 

April 2016

  • RFP Development Continues
  • Stakeholder Meeting- Tuesday, April 12, 2016  - Canceled

May 2016

  • TBD Draft RFP To The Center For Medicaid And Medicare Services (CMS) For Approval
  • Stakeholder Meeting- Tuesday, May 10, 2016  - Canceled

June 2016

  • TBD CMS Reviews RFP
  • Stakeholder Meeting- Tuesday, June 14, 2016 

July 2016

  • TBD CMS Reviews RFP
  • Stakeholder Meeting-Tuesday, July 12, 2016 

August 2016

  • TBD RFP Released
  • Stakeholder Meeting-Tuesday, August 9, 2016 

September 2016

  • TBD RFP Bidder Question And Answer Period
  • Stakeholder Meeting- Tuesday, September 13, 2016                               

October 2016

  • TBD RFP Responses Due End of Month
  • Stakeholder Meeting- Tuesday, October 11, 2016

November 2016

  • TBD Review and evaluate RFP Responses
  • Stakeholder Meeting- Tuesday, November 8, 2016                                                  

December 2016

  • TBD Prepare Instructions for RFP Oral Presentations
  • Stakeholder Meeting- Tuesday, December 13, 2016                                                               


 

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