View the Executive Summaries

The State of Health in Missouri: Coverage, Access, and Health Status 

How does Missouri rank nationally on key indicators of health? What opportunities does federal health care reform offer Missouri to improve health care coverage, access, and the health status of its residents?  View this issue brief

Uninsured Prescription: Policy Options for Covering Missouri’s Uninsured

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and the Patient Protection and Affordable Care Act (ACA) of 2010 are designed to substantially reduce the number of uninsured Americans. Both pieces of legislation offer funding, financial incentives, and a number of unprecedented policy reforms to increase access to health insurance through the nation’s existing system of coverage. This paper provides an overview of ACA’s impact on the uninsured and examines their strengths and limitations in the context of Missouri. View this issue brief

Coverage Issues for Missourians with Chronic Health Care Condition

Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 —in particular, the provisions that change the rules regarding sale of insurance to individuals and small groups—will go far toward making coverage available and affordable to uninsured people in general and to the chronically ill in particular. Most notably, when the Act takes full effect in 2014, people seeking coverage as individuals, rather than through an employer, cannot be denied coverage because of their medical conditions, and neither individuals nor small groups can be charged more because of the health status of individuals being insured. View this issue brief

Electronic Health Records and Health Information Exchange

Modern health information technology (HIT) offers unprecedented opportunities to improve health care for Americans, promising better quality at a lower cost. Policymakers from all spheres have demonstrated a strong interest in using electronic health records (EHR) and an electronic health information exchange (HIE) to achieve a health care system that is efficient, effective, safe, accessible, transparent, and affordable for all Americans. View this issue brief

Addressing Medicaid Fraud and Abuse: Facts and Policy Options

This issue brief discusses what health care fraud is, summarizes some of the attempts at the federal and state levels to address fraud, and then discusses further policy options that Missouri might wish to consider to cope with this problem. View this issue brief

Meeting the Needs of Missourians Who Are Elderly or Have Disabilities: Long-Term Care

Most individuals prefer to receive long-term care services in their own homes or in a community-based residential setting rather than a nursing home. Meeting this growing demand poses significant policy and financial challenges for Missouri in the years ahead. View this issue brief

Treating the Whole Missourian: Mental Health and Substance Use Disorders

This brief summarizes policy options relevant to behavioral health care issues, with specific attention focused on opportunities newly available in the Patient Protection and Affordable Care Act (ACA). View this issue brief

Basic Pharmacy Reimbursement Principles in MO HealthNet

This issue brief is written for individuals who are unfamiliar with the basics of Medicaid prescription drug pricing, and provides a basis for reviewing future policy implications facing state Medicaid programs, including MO HealthNet (Missouri’s Medicaid program). View this issue brief

Buying Value: Improving the Quality of Missourians’ Health Care

The residents of Missouri could get better value for their health care dollars with improvements in the quality of care and patient safety. State health policy plays a vital role in making this happen. View this issue brief

Real Opportunities for Ending the Addiction: Tobacco Use Prevention and Cessation

Given the information on the death, disability, and costs that result from tobacco use, policymakers are faced with the challenge of designing effective tobacco-control policies. Missouri’s tobacco-control policies could be strengthened to reduce the incidence and impact of tobacco use, including cessation programs, smoke-free indoor air legislation, tobacco tax, and regulatory policy. View this issue brief

Transforming Missouri Medicaid: Federal Waiver Options and Processes

Two key programs, Medicaid and the Children’s Health Insurance Program (CHIP), are important sources of financing for health care services for low-income Missouri adults and children. Both programs are financed jointly by the state and federal governments, and are operated by states under federal guidelines that are set forth in law, regulation, and policy letters issued by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees these programs.

Under waiver authority created by Congress, CMS can grant a state’s request to deviate from statutory and/or regulatory requirements that may stand in the way of service expansion or innovation. While MO HealthNet already operates elements of the Medicaid program in Missouri pursuant to a number of waivers, the ongoing transformation of the program and efforts to cover the uninsured may benefit from further flexibility attained through additional waivers. View this issue brief

Assuring an Adequate Health Care Workforce in Missouri’s Medically Underserved Areas

This paper addresses two issues: First, the challenges Missouri faces in establishing and maintaining an adequate health care workforce to meet the needs of rural and other medically underserved areas; and second, the opportunities federal health care reform offers Missouri to expand the availability of appropriately qualified health care providers in medically underserved areas of the state. View this issue brief