'Growing Pains': Providers, Members Adjust To Changes Under SoonerSelect Managed Medicaid

It's been just over a month since the Oklahoma Healthcare Authority rolled out SoonerSelect, a new managed care version of Medicaid coverage for the state.

News 9 has been tracking the transition from the start.

"The purpose is to improve the quality of life in Oklahoma while reducing the cost of care for those who are sick," Dr. Rachel Franklin, an OU Health Family Care Physician, said.

On April 1st, SoonerSelect transitioned Medicaid recipients in Oklahoma from SoonerCare to one of three third-party health plans: Aetna BetterHealth, Humana Healthy Horizons and Oklahoma Complete Health.

"We've all been told as providers that everything will be the same. Pay will be the same, pay codes will be the same, we just have to run them through these companies. And that's not what we're experiencing at all," Shay Espinosa, a licensed professional counselor in Moore, said in an interview just after the rollout.

Espinosa says her behavioral health practice had to temporarily lay off several employees since she spoke to News 9 in April.

She's also watched several peers close their doors due to insurance claims not getting paid.

The SoonerSelect website now has a portal available for healthcare providers struggling financially due to SoonerSelect.

"With any new change there are going to be growing pains," Dr. Franklin said.

She’s encouraging providers and members to be patient and proactive.

"Fewer than 1 in 5 individual members actually participated in the process of selecting their health plan," she said.

This forced the OHCA to pair the remaining members with one of the three healthcare plans.

"One important thing for all of us to is that the healthcare authority has not changed their availability for us," Dr. Franklin said.

OHCA restated its commitment to members and providers, saying it's '...already seen over 78,000 [insurance] claims paid since the transition began.’

"I think in the long term this is going to be a good thing that provides extra services to our patients to try to help keep them healthy," Dr. Franklin said.

The three companies with SoonerSelect are also hosting virtual office hours as the transition continues.

If you have concerns as a member, you can call 800-987-7767 or email soonerselect@ohca.org.

Providers are encouraged to use that email as well, or visit the OHCA’s website HERE: