HP Lands $281 Million Medicaid Contract with Oklahoma Health Care Authority

Hewlett-Packard Co. said that it has secured a seven-year, $281 million contract extension with the Oklahoma Health Care Authority (OHCA) to help the state prepare for health care reform and improve access to services.

HP said that it will act as Oklahoma’s fiscal agent, a role it has filled since 2002, providing systems support, business process outsourcing and applications development for the state’s Medicaid Management Information System (MMIS), the latter a service it did not provide in the prior agreement.

The OHCA handles Medicaid benefits, under a program called SoonerCare, for some 750,000 Oklahoma residents and processes about 40 million claims per year. The state said that it expects health care reform will add about 240,000 members to its Medicaid roster.

“Oklahoma, like most states, is preparing for healthcare reform by streamlining costs and getting ready for a significant influx of new members,” said Mike Fogarty, OHCA chief executive.

Under terms of the contract, HP will upgrade an existing portal for OHCA’s medical providers and build a web-based outlet for Oklahoma’s SoonerCare Medicaid members to apply for and track benefits.

The vendor also said that it will help the state to add medical coding under the latest International Classification of Diseases and adhere to federal Health Insurance Portability and Accountability Act (HIPAA) 5010 requirements for electronic business processes and workflows.

For SoonerCare members and medical providers, HP’s services will encompass online enrollment, eligibility, claims processing, call center and help desk support. For Oklahoma’s premium assistance program, called Insure Oklahoma, HP will process members’ applications, eligibility and call center support. In addition, it will recruit and train providers to navigate the MMIS process.

Susan Arthur, HP Enterprise vice president, U.S. Healthcare Industry, said that HP’s experience and knowledge in managing Medicaid programs for other states will benefit Oklahoma.

“Medicaid is so vital for so many that it’s imperative for OHCA to strive for the most efficient system possible for members, providers and taxpayers,” said Arthur.

“We apply the knowledge and experience from managing Medicaid programs across almost half of the United States to the applications development and other services we provide to OHCA, all with the objective of providing better service and compliance,” she said.

HP said that it administers some $95 billion in Medicaid and Medicare benefits a year as a provider of process management services and serves as the fiscal agent or principal IT provider for Medicaid in 21 states.

Under its prior contract with Oklahoma, HP, in conjunction with the OHCA, developed processes for instant eligibility determination, online provider enrollment as well as streamlining workflow.

Oklahoma last week received a $54.5 million grant from the U.S. Department of Health and Human Services (HHS) under an Early Innovators program, in which a handful of states were together awarded some $241 million to design and implement IT infrastructures necessary to operate health insurance exchanges that can be modeled by others.

The state said that it will use the grant to construct a model for eligibility and enrollment via an exchange using the current architecture for its MMIS program.