Oklahoma is failing its citizens with disabilities. Our state’s fee-for-service Medicaid program has too many barriers for people with disabilities to navigate and leaves the system unmotivated to help people receive the care and services they need to live independently.
Oklahoma providers are not encouraged by the current Medicaid program to support Oklahomans with disabilities with daily long-term support needs. Instead, they are paid based on services performed, with little or no effort to address their long-term health or preventative health outcomes. Oklahomans with disabilities currently have three options: wait months for approval, be stuck with substandard care and suffer through medical crises, or be forced into institutional settings.
Recently, we worked with someone who applied for services through Oklahoma’s Medicaid Advantage Waiver so she could receive personal care assistance in her home, which would prevent her from going into a nursing facility. She first applied for services in April. Six months later, and she still hasn’t received services. Another person applied for consumer-directed services and ended up losing his entire Medicaid benefit for six months because the state lost his paperwork. Another person contracted a severe staph infection while in a nursing home and unfortunately lost all four limbs. These incidents are avoidable and could have been prevented under a more coordinated managed care system.
For each one of these situations there are hundreds more, and it has to stop. Our current system is robbing people of their rights to live in their homes, participate fully in their communities, and contribute to the economic viability of the State of Oklahoma. Oklahoma must improve how it delivers Medicaid to provide better access to treatments, services, and doctors in a way that helps our people become healthier and provides high-quality care.
Thirty-nine other states have found a better solution: Medicaid administered through managed care organizations (MCOs). MCOs focus on preventative healthcare and care coordination to ensure every person can become and remain healthy, and they work with providers to incentivize improved health outcomes.
While many will try to argue that the state does a good job addressing outcomes to improve a person’s wellbeing; however, when you peel back the onion, what we find is that the state still operates and audits plans of care for medical terminology with no emphasis on actual outcomes and health improvements of people with disabilities.
MCOs understand how to navigate complex medical issues and can better coordinate care between multiple providers, identify services or therapies that can help people and ensure the individual is fully supported, whether that’s having enough food for the week, that they have transportation to their healthcare provider, or that they can afford their medicines.
Managed Care is the deliberate, thoughtful access to care Oklahomans deserve. This is a better solution that puts Oklahomans’ health first. It is care that you and I would want for any family member. We must do a better job of taking care of our fellow Oklahomans, and it should start by changing how we manage Medicaid in our state.