Viewpoint: Managed care looks at the whole picture when determining patient care
Oklahoma has an opportunity to change the future of health care for its children and families. With health outcomes consistently ranking in the bottom 10 among the 50 states, and one in four Oklahomans participating in Medicaid, Oklahoma not only has an opportunity but a reason to reform the health care of its people by implementing Medicaid Managed Care that employs value-based health care. The goal of value-based health care is to provide better care for individuals and communities at a lower cost.
Advocates who want to improve health outcomes for Oklahomans should support investing in a Medicaid Managed Care model with value-based care that addresses the social determinants of health, as well as the physical and mental health needs of each beneficiary, each Oklahoman.
Health advocates agree that social determinants of health play a significant role in health outcomes. That’s precisely why modern managed care focuses on the social factors that affect individual and community health. Last year in Oklahoma, the Health Care Authority's (OHCA) request for proposal required that the applying managed care organizations (MCOs) speak to these factors and how they plan to address them. There is a difference between the antiquated primary care case management model previously used in limited form in Oklahoma and the newer, comprehensive, whole-person model of care delivery envisioned by Gov. Kevin Stitt and OHCA.
Oklahoma’s expenditures on public health far outpace the health of its residents. More money isn’t the answer. There’s a more thoughtful way forward. We all recognize the need to address environmental conditions that impact public health. Instead of advocating for vague, unactionable investments in addressing social determinants, Medicaid Managed Care programs across the country have found unique, tangible ways to provide resources and partner with communities to address the specific environmental needs of those they serve.
Recent data shows that managed care produces results: It reduces health care costs, improves access to primary care physicians, improves patient satisfaction, and reduces the length of inpatient stays. Opponents of our state’s transition to Medicaid Managed Care often cite the same decade-old study that collected information from as much as 30 years ago to support the idea that managed care isn’t effective. Like most things, managed care has improved significantly over the last decade, and Oklahoma took note of the lessons learned in other states.
The bottom line? Managed care looks at the whole picture when determining patient care. Modern managed care leverages public/private partnerships to deliver value-based solutions that address housing and food insecurity, access to care, and access to social programs. If you want to address the social factors affecting health outcomes in our state, managed care, as has been proposed in Oklahoma, does just that — all while improving the way we deliver health care to nearly a million Oklahomans.
Karma Robinson is director of Oklahoman For Better Medicaid.
This article originally appeared on Oklahoman: Viewpoint: Medicaid Managed Care addresses social determinants of health
