Health IT Boosts Patient Care, Safety

HP Enterprise Services announced Wednesday that it has won a $281 million, seven-year IT services contract with the Oklahoma Health Care Authority (OHCA), extending its long-time service agreement with the state. HP will continue to act as the state's fiscal agent, providing systems support and business process outsourcing services for the state's SoonerCare Medicaid management information system (MMIS).

The agreement adds applications development services to enhance OHCA's systems. Improvements include a Web-based member portal allowing Oklahomans to apply for and track benefits online. HP also will assist the state in its efforts to add new International Classification of Diseases -- 10th Revision (ICD-10) medical coding features and adhere to the federal Health Insurance Portability and Accountability Act (HIPAA) 5010 requirements.

Nico Gomez, deputy CEO at OHCA, told InformationWeek that the recently enacted federal healthcare reform laws are directly affecting OHCA, which operates the state's SoonerCare Medicaid program.

"The law calls for extensive improvements to technology such as the use of electronic health records and creating a health insurance exchange. Like most states, these added requirements have Oklahoma facing issues such as identifying sources of funding and a shortage of a skilled workforce," Gomez said.

Gomez also noted that the aggressive timelines associated with healthcare reform implementation and other mandated programs are also creating competing demands on the workforce.

"The OHCA believes technology innovation is one of the key factors in reducing costs and developing creative ways to serve our members in times of budget challenges. Our partnership with HP has allowed us to create systems that have garnered recognition for our state as a leader in technology," Gomez said.

Through the new contract, HP will also provide SoonerCare Medicaid online enrollment, eligibility determination, and claims processing; call center and Internet helpdesk support for members and providers; an upgrade to the existing Web-based provider portal; and applications development services to enhance OHCA's systems.

OHCA manages SoonerCare benefits for more than 750,000 Oklahoma residents through 29,000 providers while processing about 40 million claims per year. The state expects as many as 240,000 additional SoonerCare members after healthcare reform takes effect.

To help with IT skills, HP recruits and trains the state's providers on navigating the MMIS process. In addition, HP provides member application processing, eligibility, and call center support for the Insure Oklahoma program, Oklahoma's premium assistance program.

Susan Arthur, VP of the U.S. healthcare industry for HP Enterprise Services, said OHCA has long been recognized for its aggressive embrace of IT with innovative, first-of-its-kind solutions. These include online member enrollment with instant eligibility determination and prior authorization automation tools as well as technologies like the e-NB1 newborn enrollment program, in which almost all eligible infants are registered in SoonerCare and assigned an initial primary care provider before the child leaves the hospital.

"These are leading-edge solutions that have drawn strong attention from a number of other states facing similar challenges and HP is proud to have partnered with OHCA in delivering these solutions," Arthur told InformationWeek. "In addition, the award of a $54 million federal Early Innovator grant to Oklahoma this week underscores the state's commitment to the problem-solving potential of healthcare IT."

HP is the nation's largest provider of Medicaid and Medicare process management services, administering $95 billion in benefits a year. It also serves as the fiscal agent or principal IT provider for Medicaid in 21 states.