Managed LTSS
In December 2013, the Missouri Senate Health Committee approved a bill to shift more children and adults into managed care and introduce a new model of coordinated care for seniors and disabled patients. The legislation moved on to the full Senate for debate. (Source: HMA Weekly Roundup, 3/19/2014)
Missouri Senate Medicaid Reform Draft Report (12/15/2013)
On May 16, 2014, the Missouri legislature adjourned; legislation to expand Medicaid managed care and establish a LTSS care coordination initiative was not passed by the legislature prior to its adjournment. (Source: ADvancing States; State Senate website)
State Demonstration to Integrate Care for Dual Eligible Individuals (Withdrawn)
In 2012, Missouri submitted to CMS a duals demonstration proposal for a managed fee-for-service financing model. Under the proposed demonstration, Medicare would share any savings realized from the state’s two Health Homes programs. (Source: Demonstration Proposal)
As of May 2014, the state has withdrawn its duals demonstration proposal. (Source: Kaiser Duals Demonstration website, 4/24/2014)
Anthem is launching a Dual-Eligible Special Needs Medicare Plan (DSNP) to help coordinate care and benefits for dual eligibles in Jefferson, St. Charles, St. Louis, and St. Louis City counties. The plan is called Anthem Dual Advantage; it was available for enrollment beginning October 15, 2014 with an effective date of January 1, 2015. (Source: Business Wire, 10/22/2014)
Balancing Incentive Program
In June 2012, CMS awarded Missouri an estimated $100.9 million of enhanced Medicaid funds (a 2% enhanced FMAP rate). (Source: CMS Balancing Incentive Program website)
CMS Award Announcement (6/13/2012)
BIP application (link no longer available 3/28/2012)
Structural Change Work Plan (link no longer available)
Health Homes
In 2011, CMS approved the state’s two Health Homes State Plan Amendments, effective January 1, 2012. The first Health Home program targets Medicaid beneficiaries with a serious and persistent mental health condition; or a mental health or substance abuse condition and another chronic condition or risk of developing another chronic condition due to tobacco use. The second Health Home program targets Medicaid beneficiaries who have two or more chronic physical conditions; or one chronic condition and risk of developing another chronic condition. (Source: Demonstration Proposal)
Missouri Community Mental Health Center Health Home SPA (10/20/2011)
Missouri Primary Care Practice Health Home SPA (12/22/2011)