State Saves Millions in Health Care Costs, Improves Quality
- The Client: Oklahoma Health Care Authority
- Total Enrollment: 802,183
- The Challenge: Reduce costs to the state through decreased utilization and improved health outcomes.
- The Solution: Increased education and support to high-cost, high-risk members and their primary care providers.
“Telligen has been instrumental in building this strong & comprehensive program . . .
Proving itself as a sound & reliable partner.”
-Della Gregg, HMP Program Manager
Oklahoma’s Medicaid program was facing increasing costs while ranking 49 out of 50 states for clinical performance measures. The performance results and high-costs led the state’s Medicaid agency to contract with Telligen to create the SoonerCare Health Management Program (HMP) in 2008.
Telligen identifies members that are high-risk or at-risk for developing chronic conditions; then works with primary care physicians to provide higher-quality, more patient-centered and cost-effective care.
- Health Coaching: Nurse health coaches embedded within primary care practices providing members with one-on-one health coaching, telephone support, and home visits. The health coaching component has demonstrated a net savings of $165.4 million.
- Practice Facilitation: On-site practice facilitators work directly with providers to redesign clinical processes and eliminate gaps in care. Increased compliance with evidence-based guidelines has saved the state an additional $123.1 million.
- Cost Savings: The program, now in it’s tenth year, has saved Oklahoma taxpayers a total of $288.5 million.
- High Satisfaction: Results from the latest independent evaluation show 90 percent of members reporting a “very satisfied” experience.
- Clinical Improvement: Significant improvement on 9 of the 17 clinical quality measures defined by the state.