Advocates Worry That Patients Will Fall through Cracks during Medicaid Managed Care Rollout in Missouri

By Liss, Samantha | St Louis Post-Dispatch (MO), April 16, 2017 | Go to article overview

Advocates Worry That Patients Will Fall through Cracks during Medicaid Managed Care Rollout in Missouri


Liss, Samantha, St Louis Post-Dispatch (MO)


On May 1, 250,000 additional Medicaid recipients in Missouri will be enrolled in a managed care system, and advocates and health policy experts say they are worried that not enough has been done to make them aware of the changes.

Patients could fall through the cracks because of the confusion, say policy experts with the Missouri Foundation for Health.

"Serving this population is really hard, and you better plan for it carefully or there can be some real pain among the participants," said Jeanette Mott Oxford, executive director of Empower Missouri.

Currently, three companies provide managed care for most Medicaid recipients in 54 counties along Interstate 70. Beginning May 1, recipients in all of Missouri's 115 counties will be under managed care. Seniors and disabled people are not affected by the change.

Medicaid is a government-funded health insurance program for low-income individuals, financed by both the state and federal government. In Missouri, Medicaid covers nearly half of all children and nearly half of all births.

There are two systems in Missouri to deliver Medicaid benefits: fee-for-service or managed care. In fee-for-service, participating health care providers are paid for each service performed. But nationwide, more states are moving to managed care, where private insurance companies are paid a set fee each month for each participant. This system provides an incentive for the insurance companies to actively monitor participants' health care use in an attempt to keep costs below the monthly allotment.

Adding to the confusion this year, Aetna, which had been managing care for 55 percent of Medicaid recipients in Missouri, will no longer be an option.

UnitedHealthcare was awarded the contract, beginning May 1. The other companies with plans are WellCare and Home State Health Plan, a division of Clayton-based Centene. …

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