SoonerCare 2016 readmissions penalty data available

Posted on: 4/26/17


The Oklahoma Health Care Authority (OHCA) has completed analysis of calendar year 2016 data for the Hospital Potentially Preventable Readmissions (PPR) program.

The OHCA uses software developed by 3M to objectively quantify the number of PPRs that would be expected for an individual hospital, based on statewide data. This hospital-specific PPR rate takes into account the DRGs, age groups, and behavioral health comorbidities associated with each hospital’s case mix. Several other state Medicaid programs also use 3M’s software to identify and help reduce PPRs.

The OHCA has established a target PPR rate for 2016 data that is 101 percent of the PPR rate of a hospital performing at the statewide average. Hospitals performing above the target rate will be assessed a penalty based on the number of PPR chains above that rate. Hospitals below the target rate will have no penalty assessed.

Hospitals may be assessed a penalty. The penalty per hospital will vary and will be recouped over eight weeks beginning May 2017 and ending in June 2017. Per diem facilities (Freestanding Psychiatric Hospitals, Psychiatric Residential Treatment Facilities, IHS/Tribal) are included in the analysis but excluded from penalties, so these facilities may receive informational only data related to the program, but penalties will NOT be assessed.

For more information, see letter 2017-05 on OHCA’s Provider Reimbursement Notices page. (Rick Snyder)

Save the dates for OHA 2022 events

Posted on: 2/18/22


It’s a new year and a new lineup of important events for you and your staff. Don’t miss out on these opportunities to engage in advocacy, education and networking all year long. Mark your calendar now!

OHA Advocacy Day - Tuesday, April 5, Oklahoma History Center. Join us for our annual legislative day. We will begin with a member briefing at 3 p.m., followed by a legislative reception at 5 p.m. Watch for registration materials soon.

OHA-PAC Golf Tournament - Tuesday, June 21, Jimmie Austin Golf Club at OU, Norman. Time and details TBA.

OHA Health Care Leaders Forum - Tuesday, July 19 - Thursday, July 21, Shangri-La Resort, Grand Lake. Watch for registration soon!

OHA Connect 22 - Wednesday, Nov. 9 - Friday, Nov. 11, Oklahoma City Convention Center and Omni Hotel, downtown Oklahoma City. Plan now to attend OHA’s annual conference and exhibit hall. More details to come.

Details on these events and other upcoming education opportunities will be available on the OHA website.