1. PIC Oklahoma PIC Oklahoma Learning Session 2  Chattanooga, Tennessee  March 30 – April 1, 2004 Educate Process Remind Increase number of successfully renewed medical cases by decreasing automatic case closures by 80% by March 1, 2004

2. Oklahoma’s Structure FNo face-to-face interview requirement FSelf-declaration of income and resources FSix months’ continuous eligibility for children FSynchronized eligibility FDetermine eligibility for all categories prior to denial/closure FMaintain eligibility when families move from county to county FReinstated automatic closures process 07/02

3. Current Events Concurrent Managed Care Transition  Board voted 11/7/03 to eliminate Managed Care Organization program  Transition of nearly 200,000 clients from Managed Care to Fee-for-Service to Primary Care/Case Manager program in 4 months  Aggressive member outreach campaign  Provider contracting to extend network statewide  Expanded care management & program supports

4. Reminders Alternative Process Process Analysis Action Period 1

5. Letter reminders include information on calling for phone renewal Phone reminders made early evening 1st Class letter reminders include Return Receipt Requested Reminders PDSA#1 PDSA#1 - Calling clients who had not returned their Benefit Review Form PDSA#2 PDSA#2 - Reminder letter sent to clients who had not returned Benefit Review Form PDSA#3 PDSA#3 - letter reminders sent with ‘Return Receipt Requested” Phone reminders PDSA#4 PDSA#4 - Phone reminders made early evening PDSA#10 PDSA#10 - reminder letter sent with information on renewals conducted over the phone Letter reminders

6. Phone renewal by dedicated caseworker Focus group survey of caseworkers on phone renewals Analyze case history after closure Analysis of form readability and content Analysis of renewal formAnalysis Analysis of return rates medical vs. comprehensive cases PDSA#5 PDSA#5 - Return rates of medical only and comprehensive cases PDSA#6 PDSA#6 - Survey on Benefit Review Form PDSA#9 PDSA#9 - Survey on Benefit Review Form at non-DHS site PDSA#11 PDSA#11 - Review case history of original PDSA cycles PDSA#12 PDSA#12 - Focus Group with caseworkers PDSA#14 PDSA#14 - Review reopened cases for impact on managed care enrollment

7. Alternative Process Phone renewals Phone renewal by dedicated caseworker Phone renewals on medical only cases PDSA#7 PDSA#7 - Conduct phone renewals during business hours PDSA#8 PDSA#8 - Conduct phone renewals on medical only cases during business hours PDSA#13 PDSA#13 - Phone renewals conducted by a designated caseworker

8. Results Percentage of Medical Only Cases Completed Before Deadline ***Caseload A and B (April data sets) contain some cases completed by designated worker

9. Results for Action Period 1 Implemented a process change to better the work flow by designating a worker to complete medical only reviews, including phone renewals. Reminders Analysis Alternative Process Process

10. Summary & Next Steps  Implementing alternative process  Testing impact on work flow  Education and Training