OKLAHOMA MEMBER ENGAGEMENT

NASHP Annual ConferenceOctober 17-19, 2016Pittsburg, PA

Presenter:Tywanda CoxChief of Federal & State AuthoritiesOklahoma Health Care Authority

OKLAHOMA: POPULATION 3,911,338 (2015)

Oklahoma Health Care Authority SoonerCare (Oklahoma Medicaid)

▪ One million members annually▪ 66 percent children▪ 60 percent of Oklahoma births▪ Patient-centered medical home

Oklahoma Health Care Authority SoonerCare (Oklahoma Medicaid)

▪ 1 million members annually▪ 66 percent children▪ 60 percent of Oklahoma births▪ Patient-centered medical home

OKLAHOMA: HEALTH

Tobacco use: 21 percent adult smokers Obesity: 6th worst in U.S. for adults and

high school students Heart disease: 1 in 4 Oklahoma deaths Infant mortality rate: 7.4 Poverty: 1 in 6

Source: BRFSS 2014 Adult Current Smokers

COLLABORATION WITH OSDH

Oklahoma State Department of Health▪ Oklahoma Health Improvement Plan▪ Oklahoma Perinatal Quality

Improvement Collaborative ▪ The Child Health Group▪ Infant mortality reduction▪ Shared health workgroups

ENGAGING MEMBERS: 3 PRONGED APPROACH

Clinical Engagement Approach

Technology and Social Media Approach

Agency Engagement Approach

IMPROVING BIRTH OUTCOMES THROUGH MEMBER OUTREACH

OHCA Population Care Management▪ Health Management Program▪ Practice facilitation and health

coaching SoonerQuit initiatives Community outreach and education

HIGH-RISK OBSTETRICAL CASE MANAGEMENT PROGRAM

Women identified as having a high-risk pregnancy receive an enhanced benefit package: Ultrasounds Non-stress tests Biophysical profiles Case management Throughout pregnancy

The full Population Care Management evaluation can be found at: http://www.okhca.org/research.aspx?id=87.

HEALTH MANAGEMENT PROGRAM (HMP)Health coaching includes: RNs trained in motivational interviewing Face-to-face interaction by practice-based coaches (embedded in PCP

practices) Telephonic interaction for high-risk members not aligned with a practice

with an embedded health coach Approximately 5,000 members engaged at a time

Practice facilitation: RNs trained in motivational interviewing and quality improvement Assist practices with improving office efficiency and effectiveness by

developing team-based care and improve quality of care provided to chronically ill patients

HMP OUTCOMES Health coaching had a net savings of $12.8 million (medical savings minus

administrative cost)

Practice facilitation had a net savings of $28.5 million (medical savings minus administrative cost)

HMP overall net savings in SFY2014 and SFY2015 is $41.2 million or 249 percent return on investment

95 percent of members were somewhat or very satisfied with their health coaching experience

88 percent of providers were somewhat or very satisfied with their practice facilitation experience

Health coaching participants incurred 44 percent less inpatient days than forecasted and 23 percent fewer ER visits than forecasted

Members aligned with a clinic receiving practice facilitation incurred 29 percent less inpatient days than forecasted and 8 percent fewer ER visits than forecasted

Full report can be found at: http://www.okhca.org/research.aspx?id=87under “Studies and Evaluations”.

PROVIDER INITIATIVE - TOBACCO CESSATION BEST PRACTICES

Evidence-based methodologies 5 A’s tobacco cessation

counseling Practice facilitation

PARTNERSHIP FOR TOBACCO CESSATION

SoonerQuit▪ Oklahoma Tobacco Helpline support▪ Outreach▪ Provider initiatives

Partnership between OHCA and TSET▪ 50 percent state share paid by TSET▪ 50 percent Medicaid administrative

matching

SMOKING PREVALENCE – OKLAHOMA MEDICAID

Do you now smoke cigarettes or use tobacco every day, some days or not at all?

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

CAHPS 2008 CAHPS 2010 CAHPS 2012 CAHPS 2013 CAHPS 2014 CAHPS 2015 CAHPS 2016 OUHSC 2016

47.8%45.5% 44.4% 43%

48%

36.7%33.4%34.4%

TEXTING SERVICES FOR MEMBERS

Connect4Health (Voxiva)▪ Text4baby (T4b): Pregnant women and

babies to one year of age▪ Text4kids (T4k): 1-18 years old▪ Txt4health (T4h): Older than 18 years

old

CONNECT4HEALTH HEALTH PLAN MESSAGES

Health plan messages are designed to support member engagement, satisfaction & retention: Re-enrollment /

re-determination Coverage information Services and benefits Incentives Member services numbers Connecting with lost

members

There's not much time left to renew Emily and Adam’s SoonerCare insurance. Please call 1 866 299 5634. If you already enrolled reply YES

Welcome to SoonerCare. You are covered for medical but not dental or vision services. There is no co-pay on doctor visits or prescriptions

SoonerCare has been trying to contact you. Please call 1 866 222 5938 to make sure you keep your insurance benefits

Here are some phone numbers for your phone book. Member Services 1 866 235 8864, Nurse Helpline 1 866 225 7789, Transport 1 513 227 1264

Re-enrollment reminder Benefits

Lost members Member services

Health plan messages are 100 percent customizable

CONNECT4HEALTH MESSAGING

text4baby: Don't forget your Dr.'s visit 3-8 weeks after giving birth. Your Dr. will tell you how your body is healing & talk about how you are feeling. Ask about birth control. You can get pregnant even before period is back. Drs. say wait 18 months between pregnancies for your body & baby's health.

T4b: Post-Partum Visit

text4baby: Baby should be able to move their arms & legs together, hold head up & smile at you! Questions? Ask Dr. at 4 month visit or call 800-311-2229. At the 4 mo visit, ask Dr. for the results from baby's hearing test. If baby has trouble hearing, ask Dr. about "early intervention" services to help.

T4b: Development Milestones

text4kids: Wow, James is almost 2! His Dr’s visit is coming up soon. Have you scheduled his 3 year visit yet? Reply 1 for Yes or Reply 2 for No.

T4k: Well Child Visits

text4kids: Wow! Lizzie is almost 5 and may be off to school this year! Ask Dr. if she is up to date on shots. he/she'll need her shot record to start school. Ask for a copy of her shot record for school at the next Dr's visit. Did you schedule the 5 year well visit yet? Reply 1 for Yes or 2 for No.

T4k: Immunizations

SoonerCare covers adult health care visits! Call your Doctor to schedule an appt. Need a doctor? Go to www.okhca.org/individuals.aspx?id=518

T4h: Benefits

If you smoke, we can help you quit! Talk to your Doctor about ways to help you quit and call OK Tobacco Helpline at 1-800-QUIT-NOW (800-784-8669)

If you are living with diabetes, it's important to have your HbA1c test and eye exam done every 12 months. Learn more at www.okhca.org/diabetes.

OKLAHOMA T4B ENROLLMENT: NATIONAL LEADER

Text4baby participants who enrolled between July 1, 2014 and June 30, 2015, by month, with estimated SoonerCare status and ration per 1,000 Medicaid-financed births, and cumulative enrollment since project launch, pregnant women and mothers, Oklahoma

T4B STATE ENROLLMENT CONTEST: 06/05/16 -10/08/16

Source: https://partners.text4baby.org/index.php/component/content/article/54-partners-get-involved/partners/495-2016-state-enrollment-contest

SOCIAL MEDIA

Social Media▪ Facebook ▪ Twitter▪ YouTube

Audiences ▪ Facebook: 86 percent female, 25-34

years old▪ Twitter: 62 percent female, 40 years old

SOCIAL MEDIA SUCCESSES

COMMUNITY OUTREACH AND EDUCATION

MEMBER ADVISORY TASK FORCE (MATF)

MATF

Consumer (member)

engagement Two-way dialogue

Inform agency policy and

programmatic decision making

Members and families feel

connected and included in

agency decisions

Bi-monthly

Face to face

Annual Tribal Consultation

Riverside Dental Event

Standing agenda item

Five Civilized Tribe Quarterly Meeting

Southern Plains Tribal Board

Health fairs

TRIBAL ENGAGEMENT

CONTACT

Tywanda CoxChief of Federal & State PolicyOklahoma Health Care Authority(405) 522-7153Tywanda.Cox@okhca.org