Provider fast facts

              Oklahoma Health Care Authority
Provider Fast Facts
All subsequent provider counts were derived from the total unduplicated provider
count. Some providers may be counted in multiple programs.
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 Rehabili-tation
Act of 1973. For additional copies, you can go online to OHCA’s website www.okhca.org under Research/Statistics and 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.
DDSD - Developmental Disabilities
Services Division
DME - Durable Medical Equipment
IP - Individual Plan
I/T/U - Indian Health Service/
Tribal/Urban Indian
LTC - Long-Term Care
PCMH - Patient-Centered Medical
Home
PCP - Primary Care Provider
Acronyms
Total Unduplicated Newly Enrolled Provider Count
698
Total Unduplicated Provider Count
37,640
Primary Care Provider (PCP) Capacities
SoonerCare Program Description Total Capacity % of Capacity Used
SoonerCare Choice 1,196,943 37.70%
SoonerCare Choice I/T/U 116,150 13.40%
Insure Oklahoma IP 416,973 3.36%
The data is based on the new provider IDs added to the system during the reporting month.
The effective date of the contract may or may not be in that month.
Payment Tier Code Count
Tier 1 566
Tier 2 209
Tier 3 49
Patient Centered Medical Home
(PCMH) Enrollment by Tier
These counts were computed using a different
method than indicated elsewhere on the report and
are not comparable to any other figures.
November 2011
Data is valid as of 12/14/2011 and is subject to change.
24,575
52
1,553
130 129 118 140
1,576
2,787
1,233
2,773
31,747
54
1,755
150 148 122 160
1,605
2,829
1,267
2,839
SoonerCare
Traditional
SoonerCare
Choice I/T/U
SoonerCare
Choice (PCPs)
Sooner Seniors My Life; My
Choice
Medicare Only Medically Fragile LTC Waiver Living Choice Insure Oklahoma
IP (PCPs)
DDSD Waiver
July 2011 Benchmark Current Month
Total Provider Count by Program
12,490
3,923
904
620
1,620 1,174 1,133 1,015 1,035 995 843
557 505 474 382
13,492
4,211 3,809 3,322
1,815
1,202 1,147 1,111 1,079 1,062 915
585 536 469 377
Physician Clinic Mental Health
Provider
Licensed
Behavioral
Health
Practitioner
Advance
Practice Nurse
DME/Medical
Supply Dealer
Pharmacy Dentist Physician
Assistant
Therapist Hospital Optometrist Transportation
Provider
Personal Care
Services
Extended Care
Facility
July 2011 Benchmark Current Month
Top 15 Provider Types
Due to federal regulations, the OHCA must have an approved agreement on file for all providers providing care to our members. To meet this requirement we are directly contracting with providers that had
previously billed through a group or agency. The Licensed Behavioral Health Practitioners and Mental Health Providers contributed to the increase in the provider counts. Data is based on the top 15 provider
types with the highest count.
12/14/2011
Due to federal regulations, the OHCA must have an approved agreement on file for all providers providing care to our
members. To meet this requirement we are directly contracting with providers that had previously billed through a
group or agency. The Licensed Behavioral Health Practitioners and Mental Health Providers contributed to the increase
in the provider counts.
Total Capacity represents the maximum number of members that PCPs request to have assigned within OHCA’s limit. Effective July 2011,
panels that are on hold status are excluded from the capacity calculation.
A group provider is a corporation that houses multiple individual providers. In order to provide a more accurate count, the group’s individual providers were
counted instead of the group provider. Living Choice formally known as Money Follows Person.
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Grant Nowata
Haskell
McCurtain
Marshall
Atoka
McIntosh
Okfuskee
Creek
Caddo
Washita
Osage
Choctaw
Latimer
Pottawatomie
Hughes
Cleveland Seminole
Sequoyah
Okmulgee Muskogee
Pittsburg
Mayes
Adair
Delaware
Cimarron Alfalfa
LeFlore
Ottawa
Canadian
Custer
Grady
Oklahoma
Harmon
Greer Kiowa
Beckham
Roger Mills
Dewey
McClain
Blaine Kingfisher
Major
Logan
Stephens
Garvin
Tulsa
Washington
Murray
Carter
Johnston
Pontotoc
Jefferson
Bryan
Coal
Lincoln
Payne
Comanche
Tillman
Cotton
Jackson
Garfield Noble
Pawnee
Beaver Harper Woods Kay
Ellis Woodward
Love
Wagoner
Rogers
Pushmataha
Cherokee
Texas Craig
New Mexico
Arkansas
Missouri
Texas
Colorado
Kansas
625 2,246
3,705
10,936
3,820
3,356
3,520 4,969
14,789
7,707
1,972
5,224
4,880
2,713
149,721
6,331
18,674
12,170
10,995 8,087
10,518
114,592
10,828
9,993
9,223
9,514
12,675
2,345
5,010
13,596
668
2,349 6,334
4,248
537
486
2,056
32,017
5,657
3,498 1,122 12,332
8,539
20,582
8,494
3,811
8,972
8,260
2,702
6,133
12,065
3,022
1,579
3,492
16,615 6,804
10,927
2,222
2,104
1,217
5,932
1,292
860
714
11,394
1,180
581
3,911 710
1,789
2,313 10,582
12,690
3,109
9,394
491 3,703
1 12
16
37
12
11
11 16
48
24
2
23
10
6
69
9
1,538
182
22
89
28
102 19
38
37
28
38
39
16
51
102
2
11 23
6
33
2
5 91 5
34
44
21
9
100 31
62
157
1,252
68
101
17
33
73
7
15
10
18
83
7
1
30
4
4
47
5
21 6
26
9
11 46
80
65
19
4 17
57 4
20
6
6
2
16
6
171
18
57
5
13
18
8
3
5 3 19
1
178
2
1
4 7
4
189
87
26
4
13
6
59
1
32
8
1
1
1
15
1
SoonerCare Member to Provider Ratio
12/14/2011
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Member/Provider Ratio
(# of Members per 1 Provider)
40 to 170 (28)
171 to 250 (25)
251 to 370 (16)
371 to 570 (5)
571 to 1,220 (3)
Border Counties
Members
Providers
Counties within 50 miles
of Oklahoma border
749,569 Total Members
(Excludes Insure Oklahoma members)
7,635 Total Primary Care Providers
(2,284 located out of state with 1,078
located within border counties)
November 2011
Primary Care Providers consist of all providers contracted as an Advanced Registered Nurse Practitioner, Family Practitioner, General Pediatrician, General Practitioner, Internist, and Physician Assistant.
The data above is valid as of the report date and is subject to change.