Telligen is excited to announce the results of an Oklahoma Health Care Authority (OHCA)-sponsored independent evaluation of the SoonerCare Health Management Program (HMP). The evaluation, which covered calendar years 2019-2020, reviewed the HMP’s administration of health coaching and affiliated services and their financial impacts on OHCA.
The evaluation showed the SoonerCare HMP health coaching program achieved $10.4 million in net savings to OHCA.
In addition to those savings, in 2021, Telligen partnered with OHCA on a series of value-based performance measures. Selected performance metrics included a five percent (5%) withhold of contract award dollars, with payment back to Telligen based on meeting specific performance targets. Based on the evaluation, Telligen not only achieved all the measures but exceeded thresholds by statistically significant margins. The measures included meeting specific thresholds for SoonerCare adults with diabetes receiving an HbA1c screening and a retinal screening, as well as successfully reducing emergency room visits and inpatient hospital days. In both instances, Telligen outperformed the comparison group.
“To achieve the results we did, in partnership with OHCA, is a tremendous accomplishment for Telligen,” said Neal Cohen, vice president of state health solutions with Telligen. “It speaks volumes for the passion and commitment to improving the lives of Oklahoma residents. We’re extremely proud of our HMP team and look forward to continuing to partner and innovate with OHCA.”
A key driver of success in the HMP program comes from identifying members who have or are at-risk of developing chronic conditions. Telligen’s health coaching model achieves success through collaboration with primary care providers, ensuring the delivery of evidence-based, patient-centered, cost-effective care.
Along with the savings impacts of the program, Telligen received high satisfaction marks from participating members and providers. Members were overwhelmingly positive about the role of the health coach, with nearly 99 percent of both initial and follow-up survey respondents stating their coach had been “very helpful” to them. The report specified the high satisfaction levels as particularly noteworthy, given the vulnerability of the SoonerCare HMP population to COVID-19, both in terms of risk factors (e.g., age and co-morbidities) and the impact of the pandemic on the health care delivery system.
Independent evaluations of Telligen’s work in Oklahoma are performed by Pacific Health Policy Group, under the direction of the Oklahoma Health Care Authority.
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About the Oklahoma Health Care Authority
The Oklahoma Health Care Authority (OHCA) administers Oklahoma’s Medicaid program, commonly known as SoonerCare. SoonerCare works to improve the health of qualified Oklahomans by ensuring medically necessary benefits and services are available. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. Currently, there are 1,175,582 Oklahomans enrolled in OHCA’s programs. The agency contracts with a network of approximately 70,000 providers. For more information, visit oklahoma.gov/ohca.