SoonerCare fast facts

              December 2011
SoonerCare Fast Facts SoonerPlan, 40,682, 5%SoonerCare Choice, 477,285, 64%SoonerCare Traditional (Fee-For-Service), 231,335, 31%
Data was compiled by Reporting & Statistics as of the report date. Numbers frequently change due to certifications occurring after the data is extracted and other factors. This report is based on data within the system prior to the report date. A majority of the data is a “point in time” representation of the specific report month and is not cumulative. Unless stated otherwise, CHILD is defined as an individual under the age of 21. The data is valid as of the report date and is subject to change.
CHIP Breakdown of Total Enrollment
Members qualifying for SoonerCare (Medicaid) eligibility under the CHIP program are under age 19 and have income between the maximum for standard eligibility and the expanded 185% of Federal Poverty Level (FPL) income guidelines.
The Insure Oklahoma is a program to assist qualifying small business owners, employees & their spouses (Employer-Sponsored Insurance—ESI) with health insurance premiums and some individual Oklahomans (Individual Plan—IP) with limited health coverage. www.insureoklahoma.org
Note that all subsequent figures are groups within the above total enrollment num-bers (except Insure Oklahoma). SoonerPlan members are not entitled to the full scope of benefits only family planning services are covered.
Delivery System Breakdown of Total Enrollment
Age Breakdown% of FPLCHIP EnrolleesPRENATAL2,446 INFANT150% to 185%1,380 01-05133% to 185%10,166 06-12100% to 185%26,903 13-18100% to 185%19,171 Total60,066
Other Enrollment Facts
Total Enrollment including Insure Oklahoma—
Unduplicated enrollees State Fiscal Year-to-Date (July through report month including Insure Oklahoma) —
Other Breakdowns of Total Enrollment
Oklahoma SoonerCare (Medicaid) members residing in a long-term care facility —
Oklahoma persons enrolled in both Medicare and Medicaid (Dual Enrollees) —
Qualifying GroupAge GroupEnrollment% of TotalAged/Blind/DisabledChild19,3052.58%Aged/Blind/DisabledAdult130,96717.48%Children/ParentsChild463,97061.92%Children/ParentsAdult71,8319.59%OtherChild570.01%OtherAdult20,752 2.77%1,3260.18%SoonerPlan (Family Planning)40,6825.43%TEFRA4120.05%Total Enrollment749,302Adults260,89035%Children488,41265%Oklahoma Cares (Breast & Cervical Cancer)TOTAL ENROLLMENT — OKLAHOMA SOONERCARE (MEDICAID)
Race is self-reported by members at the time of enrollment. The multiple race members have selected two or more races. Hispanic is an ethnicity not a race. Hispanics can be of any race and are accounted for in a race category above.
Age Breakdown of Total Enrollment471,797 219,717 57,788 Children Age 18 and Under, 63%Adults Age 19 to 64,29%Adults Age 65 and Over,8%
Small Businesses
Enrolled in ESI
Employees w/ESI
Individual Plan (IP) Members
ChildrenAdultsPercentPregnant WomenAmerican Indian61,60525,43912%3,025Asian or Pacific Islander7,9123,8792%603Black or African American64,17635,63413%2,383Caucasian318,731189,12168%17,238Multiple Race35,9886,8176%1,326Hispanic Ethnicity91,19615,66114%4,320Race Breakdown of Total EnrollmentOTHER Group includes—DDSD State-PKU-Q1-Q2-Refugee--SLMB-Soon to be Sooners (STBS) and TB patients. The Total Enrollment figure makes up 440,477 cases. A case is used to group members of the same family living in the same household.For more information go to www.okhca.org under Individuals then to Programs. Insure Oklahoma members are NOT included in the figures above.15,759107,909892,3555,12917,74713,877
1/9/2012
New Enrollees
Oklahoma SoonerCare members that have not been enrolled in the past 6 months.
Adults7,256Children10,329Total17,585780,926December 2011
SoonerCare Fast Facts 0 -50%, 213,66751 -100%, 150,094101 -133%, 92,575134 -150%, 28,362151% and Above, 259,518No Poverty Data, 5,086
Percent of Federal Poverty Level Totals
This publication is authorized by the Oklahoma Health Care Authority in accordance with state and federal regulations. OHCA is in compliance with the 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 web site www.okhca.org under Research/Statistics and Data/Total Enrollment. (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.
723,157733,285735,111743,354749,569749,302680,000690,000700,000710,000720,000730,000740,000750,000Jul-11Aug-11Sep-11Oct-11Nov-11Dec-11
December 16, 2011
OHCA Contacts: Jo Kilgore - (405) 522-7474, Carter Kimble - (405) 522-7510
SoonerQuit Helps Oklahoma Land In Top Five Most ―Quit-Friendly‖ States For Tobacco
OKLAHOMA CITY – A new report conducted by the American Lung Association (ALA) places Oklahoma as the number four ―quit-friendly‖ state for tobacco users. The ALA report looked at federal and state level actions that make it easier for smokers to quit, including what tobacco cessation treatments are covered by a state’s Medicaid program. SoonerCare (Oklahoma Medicaid) provides all seven FDA approved medications to help smokers quit. Nicotine gum, patches, lozenges, inhaler, nasal spray, Chantix and Zyban are all covered.
The following five states had the highest scores for their overall efforts to help smokers quit: Maine, North Dakota, Delaware, Oklahoma, and Wyoming. Oklahoma was the only state in the region to make the top of the list.
This is encouraging news for state initiatives that have been put into action to help Oklahomans who want to quit smoking.
The Oklahoma Tobacco Settlement Endowment Trust (TSET), Oklahoma State Department of Health, the Centers for Disease
Control and Prevention (CDC) and the Oklahoma Health Care Authority (OHCA) have been working together to educate and combat tobacco usage among SoonerCare members. OHCA will soon enter into an agreement with TSET to bring down federal matching dollars to help pay for SoonerCare members usage of the Oklahoma Tobacco Helpline. (Interested parties can call 1-800 QUIT NOW to receive free information on quitting tobacco and one-on-one, telephone counseling with Quit Coaches.)
―We know the devastating effects smoking tobacco has on the health of an individual and our communities,‖ said Mike Fogarty, CEO of the Oklahoma Health Care Authority. ―As a purchaser of health care, it is our responsibility, and a wise investment, to make sure the appropriate resources are available to those who are looking for help quitting.‖
The CDC estimates tobacco use rates for SoonerCare members are as high as 58 percent, much higher than the state’s average of 23.7 percent. OHCA has focused in on specific SoonerCare populations creating the following two programs for the SoonerQuit initiative: SoonerQuit for Women: Encourages women of child-bearing age to talk to their doctor about quitting smoking. (This campaign is closely modeled after the successful MassHealth initiative that received accolades in the ALA report.) SoonerQuit Prenatal: Educates SoonerCare obstetric providers on best practices for tobacco cessation for their patients. This is a systems level change that could potentially improve the birth outcomes in the state.
Oklahoman’s can also visit www.OKhelpline.com to register and receive services and support through the Web.
―We are proud of the recognition Oklahoma has received as a result of many years of strategic and collaborative effort on the part of organizations and individuals driven to improve the health status of our population,‖ said Tracey Strader, executive director of the Tobacco Settlement Endowment Trust (TSET). ―The Oklahoma Health Care Authority has made the most effective tobacco treatments available to Oklahomans most in need. This not only improves the health of Oklahomans in the SoonerCare program, but it also reduces the cost to taxpayers of treating tobacco-related illnesses. For every person who quits smoking, the CDC estimates that $1,623 is saved every year in excess medical costs alone.‖
Total Enrollment Trend
The “No Poverty Data” group consists of members with no poverty data and members enrolled with an aid category of U- DDSD State, R2 - OJA not Incarcerated, or R4 - OJA Incarcerated. These aid categories do not require poverty data or do not use the poverty data.