An Oklahoma Plan for Universal and Affordable Health Coverage

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An Oklahoma Plan for Universal and Affordable
Health Coverage

• By Kim Holland
• Oklahoma Insurance Commissioner

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Our initial efforts have focused upon identifying
our challenges.

• Critical among them are
• Access
• Quality
• Cost
• Collaboration and Communication

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Access

• Access to adequate primary care services and
  quality chronic care and hospital services, as
  well as higher infrastructure costs have created
  health care inequities in rural Oklahoma.
• Medical provider manpower shortages are affecting
  all parts of our state, but particularly in rural
  areas

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Access

• The individual health insurance market, while
  robust in terms of coverage options, is not
  guaranteed issue forcing individuals to the very
  expensive Oklahoma High Risk Pool, or to remain
  uninsured.
• The developing cultural attitude amongst
  individuals, business and government that health
  care is a right but health insurance is optional
  must be overcome and realigned to reinforce
  mutual responsibility and accountability.

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Quality

• Oklahoma enjoys many high quality health care
  facilities and providers, yet poor continuity of
  care in many segments of our population,
  particularly our elderly, cause us to rank low in
  terms of overall quality

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Quality

• As with many of our southern neighbors, Oklahoma
  ranks poorly in terms of population health. High
  rates of obesity, smoking, cancer, heart disease
  and diabetes coupled with inadequate chronic
  disease management efforts, result in high
  utilization rates. High numbers of uninsured,
  persistent poverty and poor nutrition exacerbate
  these problems.

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Cost

• We do not have and must acquire a comprehensive
  understanding health care spending in Oklahoma.
• Oklahoma is a poor state. Our need to identify,
  allocate and leverage resources to fund necessary
  reforms, and muster the political will to do so,
  is essential.

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The Oklahoma Plan

• An Oklahoma Plan is emerging from SCI Team
  meetings, discussions and investigations. It
  includes making universal coverage a
  centerpiece objective and catalyst for overall
  health care system improvement.

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Our objectives are to be focused in four primary
categories

• Access Both to coverage and to care
• Quality and Performance Identification of low
  hanging fruit in terms of quality improvement
  and opportunities for maximum return on
  investment

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• Cost and Finance Leveraging our resources to
  identify revenue streams, maximize federal match,
  eliminate waste and improve efficiencies
• Collaboration and Communication Identification
  and recruitment of stakeholders and opinion
  leaders for education and advocacy development
  of key messages

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Proposed Use of SCI Funds

• The SCI Grant funds will be used to develop and
  promote the expanded health insurance coverage
  component of the overall Oklahoma Plan.

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• POPULATION ANALYSIS Verifying, analyzing, and
  reformulating the HRSA funded statewide analysis
  performed by SHADAC. The purpose is to insure
  that the actual coverage implementation plans are
  focused upon the correct target population.
  Clearly identify and quantify our uninsured
  population who they are (demographic, socio
  economic, employment status) and where they are
  (urban/rural, region)

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• CREATING CORE HEALTH PLANS Broadening and
  deepening the reach of the Oklahoma CHAT process
  to include a larger number of more varied and
  targeted cohort responses such as insurers,
  employers, and health care providers. Additional
  CHAT survey work will allow the administration of
  a refined series of survey questions to help
  craft the final products. The process will
  include more community meetings statewide.

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• AFFIRMING AFFORDABILITY Creating an analysis
  process similar to CHAT that will properly assess
  the affordability of (willingness to buy) the
  products designed as core plans. The analysis
  will also determine Oklahoma specific responses
  to willingness to buy affordable products and
  those incentives and subsidies needed to promote
  statewide acceptance. Thorough development of an
  affordability scheme to determine mandatory
  employer and/or individual contributions to
  coverage, state government subsidization,
  probable revenue streams and maximization of
  opportunities for federal matching funds,
  coercive tax incentives

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• OUTREACH AND COMMUNICATION A full year of
  coordinated effort to craft and communicate the
  essential messages to assist passage of
  significant reform legislation. This effort may
  secure the services of higher profile sponsors
  and/or facilitators to bring and fix attention on
  the essential issues.

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• The Plan is to marshal a variety of revenue
  sources, using the SCI grant as a catalyst. The
  aggregated dollars will be used to create The
  Oklahoma Health Institute (OHI). The Oklahoma SCI
  Team will become the charter Advisory Board to
  the OHI and the Board will direct the OHI scope
  of work.

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• Our ability to affect a meaningful and
  sustainable plan for universal coverage must be
  developed from sound and reliable data. And, it
  is imperative that we take our vision to the
  public and engage their support. To that end,
  the development grant will provide financial
  support for our effort.

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• The OHI will then undertake the tasks necessary
  to
• (1) prepare the state for the consideration of
  health reform legislation beginning in 2008 (The
  Oklahoma Personal Responsibility for Health Care
  Act) and as necessary thereafter to accomplish
  universal coverage by 2010 and
• (2) coordinate with the parallel health
  improvement and cost moderation activities by
  other state entities.

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• Our team is representative of key constituencies.
  They are the voices for change and they believe
  that health care reform is the most critical
  issue facing our state. They want to be involved
  and stay involved until we get the job done.

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An Oklahoma Plan for Universal and Affordable
Health Coverage

• By Kim Holland
• Oklahoma Insurance Commissioner