EDITORIAL: Legislators correct to be skeptical of managed care

Feb. 23—Funding Medicaid expansion in Oklahoma is the biggest issue facing the Oklahoma Legislature this year. After Oklahomans narrowly passed Medicaid expansion that was brought to vote through initiative petition, the clock is ticking to secure the multi-million-dollar funding on the program, which must begin July 1, 2021.

Oklahomans later failed to pass a measure decreasing TSET funding to help pay for the program. Gov. Kevin Stitt swiftly began the push to leap into a managed care system for SoonerCare or Medicaid. His managed care proposal would outsource the state-run Medicaid program to four different insurance companies in an effort to improve health outcomes and stabilize costs. The insurance companies would be compensated for running the program, and doctors and dentists would be paid less for treating SoonerCare patients.

The proposal for managed care has been met with skepticism by legislators on both sides of the aisle. During Stitt's State of the State speech, legislators were glaringly skeptical of this plan and rightly so. Past attempts at managed care in Oklahoma have been troublesome, and the current plan is opposed by the state's medical, dental, pediatric and osteopathic associations. That's a clear sign the Legislature needs to looks carefully at states where managed care is in place before funding the new Oklahoma plan.

In the 1990s, Oklahoma tried a managed care approach, which the Oklahoma State Medical Association called "disastrous." They and other health care organizations say managed care will create an access crisis for an Oklahoma population that already faces a serious shortage of health care providers while combating a worldwide pandemic. The bureaucratic red tape and delayed payments OSMA says was a reality of managed care forced many state physicians to stop taking Medicaid patients the last time. Regardless of the intent to curb costs while expanding services, they say the number of physicians willing to serve the Medicaid population will decline, especially in rural areas of the state. OSMA recently announced its intent to file a motion asking the Oklahoma Supreme Court to issue an injunction against Medicaid managed care contracts moving forward.

While we agree with their concerns, those who are opposing the managed care option need to offer a solution. This will be the battle in the Legislature in the weeks ahead. Legislators must see what is working in other states, and possibly work with health experts to craft legislation that will make the managed care option more palatable and workable.

The bottom line is that we must have a system that is financially efficient and delivers the health outcomes we all desire.

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