OHCA Distributes $11.5 Million to Oklahoma Providers through Incentive Payment

Oklahoma City, OK – The Oklahoma Health Care Authority has distributed more than $11.5 million to qualifying providers under the new SoonerSelect Provider Incentive Directed Payment Program. This program is designed to incentivize health care providers to offer premium preventive and primary care services to SoonerSelect members.

This payment was the first in a series of payments that will be distributed quarterly. A total of $134 million is expected to be distributed over the first 15 months of the program.

"The SoonerSelect Provider Incentive Directed Payment Program represents a major investment in the health and well-being of Oklahomans,” said Ellen Buettner, OHCA Chief Executive Officer and Chief Health and Mental Health Advisor. “By incentivizing preventive care, we are ensuring that more Oklahomans receive timely services that can prevent serious health issues down the line.”

The incentive program provides supplemental payments to physicians and other qualifying practitioners who render services aimed at improving access and quality of care for SoonerSelect health and SoonerSelect Children’s Specialty Program members. Eligible services include:

• An estimated 19% increase in payments for any covered service, including prenatal visits and vaccines, provided by an eligible provider contracted with a SoonerSelect plan. This increase may vary based on the available funding and the volume of services rendered.
• A $25 enhancement for Screening, Brief Intervention and Referral to Treatment (SBIRT), a screening process for early detection and intervention for substance use in various healthcare settings.
• A $25 enhancement for after-hours care, expanding access to services outside typical hours, excluding urgent care and hospital-based services.
• A $25 enhancement for well visits aimed at encouraging primary care visits to improve overall health and preventive care.

OHCA examines claims data to determine the amount each SoonerSelect contracted provider receives. SoonerSelect contracted providers will receive the incentive payments from the contracted entities as directed by the OHCA.

Providers eligible for supplemental payments include physicians, advanced practice nurses, mid-level practitioners, outpatient behavioral health agency providers, licensed behavioral health providers in independent practice, podiatrists, and anesthesiologist assistants who do not participate in a separate directed payment program. The payments are provided as lump-sum enhancements to the base fees paid by SoonerSelect contracted entities.

The incentive program was authorized by SB 1396 (2022) and is aligned with the objectives of the SoonerSelect quality strategy. Those objectives include promoting preventive health in adults and managing chronic conditions through enhanced primary care services. By incentivizing providers with additional payments for preventive and primary care services, the program supports improved access to and quality of health care for SoonerCare members.

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