Managing care in Medicaid managed care

Abstract

This commentary discusses the journey of SoonerCare, Oklahoma's Medicaid program, and its experience going from a statewide fee-for-service system to a partially capitated, commercial managed care system to a statewide medical home program. It describes in detail the current program and how the Oklahoma Health Care Authority, the state's Medicaid agency, addresses utilization control through various patient interventions. While the system and many of its interventions are young, the Oklahoma Health Care Authority continues to look forward in how to build upon and improve its system to ensure quality, appropriate, and efficient service delivery.