Health Care Systems Innovation
Health Care Systems Innovation (HCSI) provides continuous improvement of the SoonerCare Choice delivery system, develops strategies for program enhancement and creates stronger collaboration between existing programs. The following HCSI programs offer care coordination services for members with or at risk for chronic conditions and/or poor health outcomes and support for providers caring for them.
Health Management Program (HMP)
In 2008, the Health Management Program was developed in response to a state mandate found at Oklahoma Statute 56-1011.6, and seeks to improve the quality of care and reduce cost of care for SoonerCare members with chronic conditions. The HMP has developed into a robust care coordination model that provides practice-based, chronic disease-focused supports to SoonerCare Choice members and their PCPs. Health coaches work with members at their medical homes and over the phone, and practice facilitators work with selected facilities to improve processes related to caring for persons with chronic illness.
Pain Management Program
The Pain Management Program is a component of the HMP and is designed to equip SoonerCare providers with the knowledge and skills to appropriately treat members with chronic pain through practice facilitation and access to behavioral health resource specialists. Additional information can be found at https://www.okhca.org/painmanagement.
Chronic Care Unit (CCU)
Nurses provide case management to high-risk and at-risk SoonerCare members with chronic conditions - members whose PCP is not aligned with an in-office HMP health coach. They work to assess and address the health status and health literacy of members through care coordination, self-management principles and behavior modification techniques.
The SoonerQuit program was developed through a grant with the Oklahoma Tobacco Settlement Endowment Trust (TSET) and focuses on promoting and increasing access to tobacco cessation benefits and the Oklahoma Tobacco Helpline (1-800-QUIT-NOW). SoonerQuit staff assist providers with integrating best practices and offer technical assistance related to tobacco cessation.
Health Access Network (HAN)
OHCA has a contract with three HANs to work with affiliated patient-centered medical home (PCMH) providers to coordinate and improve the quality of care for SoonerCare Choice members. HANs offer care coordination services in targeted populations.
Program for All-inclusive Care for the Elderly (PACE)
The Program for All-inclusive Care for the Elderly (PACE) is a managed care model of acute and long-term care that integrates the provision and financing of medical and long-term care services. The PACE model is centered on the belief it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. The goal is to maximize the participant's autonomy and ability to reside in their community while receiving quality care at lower cost relative to the Medicare, Medicaid and private-pay traditional payment systems.