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Managing Care in Medicaid Managed Care

Fogarty, Mike JD, MSW; Splinter, Garth L. MD, MBA; Kimble, L. Carter MPH

Journal of Ambulatory Care Management: July/September 2013 - Volume 36 - Issue 3 - p 173–177
doi: 10.1097/JAC.0b013e3182955b37
Original Articles

This commentary discusses the journey of SoonerCare, Oklahoma's Medicaid program, and its experience going from a statewide fee-for-service system to a partially capitated, commercial managed care system to a statewide medical home program. It describes in detail the current program and how the Oklahoma Health Care Authority, the state's Medicaid agency, addresses utilization control through various patient interventions. While the system and many of its interventions are young, the Oklahoma Health Care Authority continues to look forward in how to build upon and improve its system to ensure quality, appropriate, and efficient service delivery.

Oklahoma Health Care Authority, Oklahoma City, Oklahoma.

Correspondence: L. Carter Kimble, MPH, Oklahoma Health Care Authority, 2401 NW 23rd St, Ste 1-A, Oklahoma City, OK 73107 (carter.kimble@okhca.org).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins