- (a) Primary care spending/expenses. No later than the end of the fourth (4th) year of the initial contracting period, each CE shall be currently spending not less than eleven percent (11%) of its total health care expenses on primary care services.
- (b) Primary care expenditure reporting requirements.
- (1) The CEs must submit a primary care implementation plan which describes the CEs strategies for increasing the percentage of total medical expenditures allocated to primary care over the initial four (4) year contract period.
- (2) The plan shall include target annual percentage increases over the previous year baseline data that demonstrate the CEs ability to achieve eleven percent (11%) by the end of year four (4).
- (c) Primary care expenditure calculations.
- (1) CEs shall submit data on an annual basis for primary care and total medical expenditures made through paid claims amounts and non-claims payments to the OHCA, in the manner and timeline prescribed in the SoonerSelect Contract.
- (2) The OHCA will consider non-claims-based investments into primary care including but not limited to investments in electronic health record (EHR) systems, health information exchange (HIE) costs, care coordination activities and systems, and recruitment/retention incentives for primary care providers in rural and medically underserved areas.
- (3) Other non-claims-based investments may be reviewed and approved by the OHCA.
- (4) The OHCA may impose a cap on the amount of non-claims-based investment considered in the primary care expenditure calculation.
Added at 39 Ok Reg 450, eff 12-21-21 (emergency)
Added at 39 Ok Reg 1628, eff 9-12-22
Amended at 41 Ok Reg, Number 23, effective 9-1-24