ENID, Okla. — Oklahoma Health Care Authority held a stakeholder meeting in Enid Wednesday night to gather thoughts, opinions and information on privatizing health care for aged, blind or disabled Medicaid consumers.
In the most recent session, the Legislature passed House Bill 1566, which directs OHCA to explore care coordination models for those individuals. Currently, the state contracts with providers through OHCA for their care, but under the new program, OCHA would work with third-party care providers.
Despite the small turnout at Enid’s meeting, stakeholders from care providers and a rural hospital had plenty to say about what issues they deal with now and what issues could arise from privatizing care.
Fear of change
Linda Neal, a supervisor at Health Care Innovations Private Services in Enid, said the patients they care for already have been through so many transitions, and change is not good for them.
“Some patients have been on the program for a long time, and they have a (patient care assistant) they see every day,” she said. “Some of these people don’t have family members, and the PCA is their family. And they have the case manager who checks in weekly or monthly, and that’s their advocate. That’s who they go to when something is wrong."
If the care is privatized, it’s possible the PCAs and case managers the patients are used to seeing could change, or the case managers could be eliminated altogether, Neal said.
“Sometimes, the case manager and PCA are the only people the consumer gets to see,” she said. “The case managers do a lot. Not just making sure they get their pull-ups and pads, but making sure their yard is cut or their faucet is changed or whatever they need.”
Interest is there
Andy Cohen, president of Pacific Health Policy Group, a consultant group to help OHCA gather information on coordinated-care plans, said they don’t know what such a plan will look like yet.
“That’s what we are out here to learn about,” he said.
Cohen and members of OHCA have conducted focus groups in Lawton and McAlester, and will hold meetings in Muskogee, Tulsa and Woodward soon.
Cohen said some things will not change with privatized care: eligibility for Medicaid and Medicare programs and services covered by those programs will stay the same.
Some things that could change include an increase in care availability, service providers, the way payments are made and who authorizes such services.
Buffy Heater, OHCA’s chief strategy officer, said OHCA has no preconceived notion of what the plan would look like.
“We have over 500 stakeholders who have signed up, which is unprecedented,” she said. “It’s a great thing, but I have 500 stakeholders who are representing a multitude of organizations, so the response is varied.”
Some organizations think some changes would be good, she said, but not every feels that way.
“Then you have other folks who have been in a system that works well, and there’s a lot of fear of what will change,” she said. “‘Will this change my life?’ ‘Will this change the way I receive care?’ ‘Will I be able to have what I had previously?’ It’s a full spectrum.”
Different way to pay the bills
Jennie Melendez, senior public information representative for OHCA, said Oklahoma already has a notion of coordinated care.
“There are some state Medicaid programs that don’t do any kind of coordinated care program,” she said, so patients with multiple conditions are seeing several doctors, which can result in duplicated medication and doctors not getting the full picture. “We have nurses that do monitor these patients and are acting as their case managers. Even though we haven’t had formal managed care, we have programs in place where we are already offering these services.
“We are open to improvement, but at the same time, since we are already doing it, it seems like it would be a fit for states that aren’t doing it at all because they could come in and see cost savings. We think the savings would be limited because we're already ahead of the game with managed care.”
If care is privatized, Melendez said there’s one thing consumers don’t have to worry about: cost.
“It shouldn’t cost the consumer anything,” she said. “It’s just a different way to pay the bills. If they’re enrolled in Medicaid or Medicare, they won’t see any difference in cost.”
OCHA holds monthly stakeholder meetings in Oklahoma City. The next meeting is at 2 p.m. Oct. 3, in the OHCA boardroom, 4345 N. Lincoln Blvd.
For information on the proposed coordinated care, go to www.okhca.org/ABDcarecoordination.
Asher is education reporter for the News & Eagle. She can be reached at email@example.com.