Here’s what you should know:
1. The Missouri Foundation for Health, an independent, philanthropic foundation, worries patients will fall through the cracks after the changes become effective May 1.
2. Currently, 54 state counties use a managed care system. Starting May 1, all 115 state counties will move to managed care systems.
3. Seniors and disabled residents are exempt.
4. In addition to the switch, Aetna — which previously managed care for 55 percent of Medicaid recipients — is no longer an option. The state awarded UnitedHealthcare a contract over Aetna. WellCare and Home State Health Plan will also be marketplace options.
5. The state required Medicaid beneficiaries to select from the three payers beforehand, but the Post-Dispatch reports less than 20 percent of 750,000 eligible people have done so. The state will automatically enroll the remaining beneficiaries into a plan.
6. Healthcare advocates worry the low response rate is an indicator that beneficiaries are unsure of the change.
More articles on coding, billing and collections:
States moving Medicaid beneficiaries to privatized managed care: 5 insights
The 5 largest payers in the United States
The 4 secrets to scaling your business
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
