Behavioral health fast facts, 09/2012

              Behavioral Health Fast Facts
September 2012
This publication is authorized by the Oklahoma Health Care Authority in accordance with state and federal regulations. OHCA is in compliance with Title VI and Title VII of the 1964 Civil Rights Act and the Rehabilitation Act of 1973. For additional copies, you can go online to OHCA's website www.okhca.org/research/data. The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, gender, religion, age or disability in employment or the provision of services. The data is valid as of 9/14/2012 and is subject to change.
*The Total is an unduplicated count, members are only being counted once. Member Served counts members multiple times if they have multiple Category of Services, however, they are only counted once under each category of service. **The Outpatient category consists of agencies providing mental health, substance abuse and TCM (Target Case Management). ***Totals may not sum correctly due to rounding calculations.
¹ Behavioral Health Services Reimbursement is based on category of service. It does not include diagnosis information, which may not include all the expenses related to behavioral health services. Behavioral Health Services Reimbursement average 9% (as of SFY 2011) of the overall annual SoonerCare budget (excluding Psychotropic Drugs2).
2 Prescription claims that are not coded with diagnostic information and drugs used to treat behavioral health conditions may be used for some physical health conditions as well. This figure includes all uses of the drug included within behavioral health categories.
Reporting of figures are based on the payment date of the claims. Trends from month to month vary due to sporadic billing.
$27
$27
$31
$29
$42
$33
$32
$42
$33
$30
$40
$33
$10
$10
$9
$10
$10
$10
$9
$9
$8
$8
$10
$9
$37
$36
$41
$40
$52
$43
$41
$51
$41
$39
$50
$41
0
20
40
60
Oct-11
Nov-11
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Millions
Reimbursement
BH Services Dollars***
Psychotropic Drug²***
OHCA's Behavioral Health Program provides a behavioral health care benefit for adults 21 years of age and older and children under 21 years of age who are enrolled in SoonerCare (Traditional & Choice) programs.
* The Oct-11 increase in BH providers represents OHCA’s decision to enroll providers who were previously providing services in an Outpt BH agency or CMHC without an agreement on file. The Jul-12 increase is due to a methodological change in how providers are counted by OHCA that was implemented across all providers types to better reflect the Provider Network available to members.
484,048
488,780
488,412
493,069
495,994
498,692
498,352
498,477
497,731
499,068
500,254
503,453
259,306
260,789
260,890
263,325
264,478
265,539
266,363
267,954
267,334
268,665
269,249
271,331
743,354
749,569
749,302
756,394
760,472
764,231
764,715
766,431
765,065
767,733
769,503
774,784
0
250,000
500,000
750,000
1,000,000
Oct-11
Nov-11
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
SoonerCare Enrollment
Children Under 21 (65%)
Adult Age 21 - Over (35%)
Notes: The enrollment numbers are SoonerCare only, Individual Plan (IP) is excluded, all other figures include both SoonerCare & IP
32,319
33,861
36,872
36,760
42,042
41,765
41,183
43,745
40,051
37,465
40,261
39,993
17,287
17,942
18,051
17,808
21,247
20,112
20,081
21,703
20,403
19,901
21,649
20,120
-5,000
5,000
15,000
25,000
35,000
45,000
55,000
65,000
75,000
Members Receiving Behavioral Health Services
Children Under 21
Adult Age 21 - Over
7,276
7,518
7,689
7,993
8,152
8,122
8,418
8,604
8,888
9,440
9,575
9,928
0
2,000
4,000
6,000
8,000
10,000
Behavioral Health Providers
*See note above regarding the Oct-11 and Jul-12 BH provider increases.
Reimbursement Members Served* Average per Member Reimbursement Members Served* Average per Member $194,75178$2,497$651,049248$2,625$574,360170$3,379$11,3511$11,351$8,503,972950$8,952$13,809,00034,856$396$5,395,26815,230$354$452,0141,758$257$142,831628$227$237,2872,312$103$273,0833,440$79$300,325223$1,347$1,143,818716$1,598$371,9484,010$93$239,9483,822$63$56,243167$337$229,387663$346$25,643,71839,993$1,275$6,942,91720,120$174 Psychiatrist Category of Service Children Under 21 Adult Age 21 and Over Inpatient (Acute-General) Total* (unduplicated) Residential Behavior Mgmt Services (TFC) SMI/SED Case Management Other OP Behavioral Hlth Services Residential Behavior Mgmt Services (Group) Behavioral Health Services Reimbursement1 Inpatient (Acute-Freestanding) Psychiatric Residential Treatment Facility (PRTF) Outpatient** Psychologist (Therapeutic Foster Care)
10/23/2012