MO Shifts Medicaid Patients to Private Sector

By Free Radical

Nearly 240,000 Missouri state Medicaid patients were moved to private sector companies last week.

Nearly 240,000 Missouri state Medicaid patients were moved to private sector companies last week.

Last week, Missouri transferred nearly 240,000 of its state-provided Medicaid program to private insurance companies. The new program, MOHealthNet requires individuals who are not elderly, disabled or blind to use one of three private sector businesses: WellCare, United Health Group, or Centene Corporation.

The program was offered to only 54 Missouri counties previously. Now it is offered throughout the entire state.

The program’s supporters argue that it is more cost-effective as the state pays one of the three insurance companies a flat fee for each patient. Prior to the program’s implementation, the state paid for a patient’s care directly. If there are any additional, unexpected costs, the private insurance company will now pay for them.

The new plan’s opponents say that given insurance company’s profit motive, they will attempt to cut costs by limiting services to patients.  A new feature of the program is that patients have fewer doctors in their network.

There is some evidence that supports their concerns. A report issued to the MO HelahNet Oversight Committee in 2015 showed that Medicaid patients who were serviced in the private sector were less likely to stay current on their medications, and less likely to use emergency room services. On the contrary, they were more likely to be screened for breast cancer.

Despite the claims of saving money, a study of Missouri from 2010 to 2013 showed that only 1.7% was saved due to this change.

There were also problems with the rollout of the program. Medicaid patients who were eligible for the switch were required to select a new company by April 3. If they failed to do so, they would be automatically enrolled into one of the private companies. Only about 12% of the eligible patients signed themselves up for a private insurance carrier. Therefore, it is likely that they may have not understood the changes taken place or may currently be unaware of the new policy. This will more than likely present problems the next time they need medical help.

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