HIDI HealthStats | August 2018

How Effective Are Medicaid MCOs At Managing Care In Missouri?

Key Findings

  • In May 2017, Medicaid managed care was expanded statewide in Missouri, adding 240,000 new MCO enrollees.
  • Despite the rapid growth of managed Medicaid delivery models in the U.S. and Missouri, limited evidence exists on the actual effectiveness of MCOs to deliver efficiencies and cost savings while improving health outcomes for enrollees.
  • Observed differences in hospital utilization for Medicaid beneficiaries in Missouri can be explained by higher rates of clinical, behavioral and social complexity among fee-forservice enrollees.
  • Compared to fee-for-service, Medicaid managed care patients have significantly lower clinical and behavioral risk factors, yet higher rates of ED utilization and inpatient readmissions.

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