Oklahoma saves millions in health care costs, improves quality of care
Background: With the cost of health care rising and state budgets dwindling, Oklahoma’s Medicaid program was facing increasing costs while ranking 49 out of 50 states for clinical performance. The poor performance and high costs led the Oklahoma Health Care Authority, the state’s Medicaid solutions agency, to contract with Telligen to create the SoonerCare Health Management Program (HMP) in 2008.
Strategy: Telligen helps the HMP improve value-based care delivery by identifying and engaging high-risk members, coordinating care across the continuum, and closing gaps in care.
Results: For members with chronic conditions—from heart disease to asthma to diabetes—Telligen embeds registered nurses within primary care practices and provides one-on-one health coaching, telephone support and home visits. For the fiscal year of 2015, these strategies comprised $12.8 million in total program savings with 87 percent of members reporting a “very satisfied” experience with their health coaches.
In addition, the HMP features on-site practice facilitators who help physicians redesign clinical processes and eliminate gaps in care. Results from FY 2015 show increased compliance with evidence-based guidelines saved an additional $28.4 million.
Long-Term ROI: Results from HMP’s phase one (2008 to 2013) achieved a five-year taxpayer savings of more than $180 million, returning $6 for every $1 invested.