Missouri's Medicaid Program: MO HealthNet
Medicaid Basics 2011
Missouri Medicaid Basics provides an overview and specific data on MO HealthNet. The report includes details on eligibility, key programs, delivery systems, and the financing and expenditures related to MO HealthNet. The 2011 edition has a new section that examines incentives in the federal health reform law to make changes in the Medicaid program. The report also has updated charts with regional data on MO HealthNet enrollment. View the report
See Medicaid Basics 2010.
These reports provide an assessment of the impact that the 2005 Medicaid changes have had on the financial and service health of Missouri's safety net, specifically the state's hospitals and Federally Qualified Health Centers (FQHCs). The studies, conducted by Health Management Associates (HMA), examine the impact, not on the specific individuals affected by the Medicaid changes, but on the broader health care safety net. In particular, the paper on Missouri's hospitals examines the effect of these changes on hospital's charity care, bad debt, Medicaid revenue, and percentage of self-pay patients (i.e., the uninsured). The second paper reviews three years of patient and financial data for Missouri's FQHCs - a critical component of the state's health care safety net.
View the: Hospital report | Appendices | FQHC report
This study details the impact of the cuts to the Medicaid program enacted in 2005 by the Missouri Legislature and signed into law by Governor Blunt, as well as the resulting challenges that face the state moving forward.
The Missouri Health Improvement Act of 2007 called for the creation of the Professional Services Payment Committee, also called the Pay-for-Performance (P4P) Committee, to guide MO HealthNet in the development and implementation of new incentive programs. This issue brief examines potential P4P opportunities within the MO HealthNet program in order to inform the deliberations of the P4P Committee and MO HealthNet stakeholders. The paper includes the recommendation of a five-point strategy for the consideration of the P4P Committee and those with a stake in the outcome of the Committee’s deliberations.
This paper addresses both the costs and the benefits of the Medicaid program for the state of Missouri. It breaks down Medicaid costs by health care service rendered and according to specific populations covered by the program. The paper also examines the impact of Missouri's Medicaid program on health related outcomes, access to health care and the uninsured rate.
This paper profiles cost changes in Missouri's Medicaid program over five years.
Federal Medicaid law requires states to ensure access to Medicaid services, beyond these requirements state Medicaid programs and budget officials have a measure of control over reimbursement rates. This paper presents background material on Medicaid reimbursement, a sampling of the literature on the subject, and considerations for improving provider participation in and beneficiary access to Missouri’s Medicaid program, MOHealthNet.
In most states, Medicaid physician reimbursements rates are lower than those for Medicare and private insurance. In 2003, Missouri Medicaid to Medicare fee index was 56 percent. Research indicates that raising reimbursement for Medicaid providers results in an increased number of Medicaid patients they treat. This fact sheet examines the issues related to reimbursement rates.
This issue brief provides an overview of effective state strategies to improve dental compliance for Medicaid recipients as a means to create a clinically sound pattern of primary dental care. The paper provides general recommendations and strategies to improve dental compliance among the Medicaid population.
Medicaid Programs in Other States
This paper profiles five states (Florida, Maine, Massachusetts, Oregon and Tennessee) and examines recent changes implemented in their Medicaid programs. The discussion considers the various Medicaid cost-containment measures used by these states, as well as the effect the changes have had both in terms of cost savings and human impact.
This report reviews data and linkages among cost, access and utilization of Medicaid.
This paper is a broad view of waiver activities, including those that deal with special populations.
This analysis describes policy developments in states using new Deficit Reduction Act (DRA) authority to make changes to their Medicaid programs. Four states with approved DRA-related state plan amendments are examined. The case studies provide a sense of the flexibility offered under the DRA, the limitations to that flexibility, and innovative ways states are applying the authority to meet their own particular objectives. The study provides a basis for considering how key policy elements may or may not apply in Missouri Medicaid. HMA identifies implications and considerations for safety net providers, makes recommendations for approaches that enhance positive possibilities, and suggests ways to mitigate potential negative impacts of DRA provisions.
As states have developed comprehensive Medicaid reform initiatives, some have defined and others refined a series of conceptual elements that form the parameters within which the Medicaid reform debate is being conducted. This paper and its fact sheets explore the concepts currently being used by other states in reforming their Medicaid program. In addition, HMA analyzes how these concepts, if implemented in Missouri, may impact the state's safety net.
This analysis provides an overview of Florida's current Medicaid program and the state's plan for Medicaid reform. The fact sheet includes an overview of the goals and objectives of the reform plan, as well as background on the reform process, implementation strategies, and program highlights. Highlighting the development of Florida's Medicaid reform may assist Missouri policymakers as they examine reform plans for this state's Medicaid program.
This fact sheet discusses the impact of the 2005 Deficit Reduction Act (DRA) on Medicaid policy, including provisions related to benefits and cost-sharing that states may now implement through the State Plan Amendment (SPA) process instead of the formal waiver process. It explains both mandatory and optional Medicaid changes found in the DRA, as well as how these changes may shift costs to beneficiaries while limiting coverage and access to health care services for Medicaid beneficiaries.