Legislators are reluctant to expand Missouri’s Medicaid program
because the managed care organization (MCO)-led program not as efficient as the
traditional fee-for-service (FFS) program, according to a Kaiser
Health News article. In a January presentation to the MO HealthNet Oversight Committee,
agency representatives noted that while hospital admissions are lower in the population
cared for by MCOs, but readmissions are higher. Five out of six clinical
quality measures are also worse in MCOs than FFS. In the latest contract with
the three MCOs -- Aetna, Centene and WellCare – Missouri is requiring the plans
to take more responsibility for the health of Medicaid members, including
wellness incentives. We should send MO officials CT’s
experience shifting from MCOs to a care coordination-focused model – higher
quality, more provider participation, and costs under control.Monday, March 23, 2015
Medicaid MCOs not working in Missouri, inhibiting expansion, MO could learn from CT’s experience
Legislators are reluctant to expand Missouri’s Medicaid program
because the managed care organization (MCO)-led program not as efficient as the
traditional fee-for-service (FFS) program, according to a Kaiser
Health News article. In a January presentation to the MO HealthNet Oversight Committee,
agency representatives noted that while hospital admissions are lower in the population
cared for by MCOs, but readmissions are higher. Five out of six clinical
quality measures are also worse in MCOs than FFS. In the latest contract with
the three MCOs -- Aetna, Centene and WellCare – Missouri is requiring the plans
to take more responsibility for the health of Medicaid members, including
wellness incentives. We should send MO officials CT’s
experience shifting from MCOs to a care coordination-focused model – higher
quality, more provider participation, and costs under control.
