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As Missouri shifts Medicaid patients to private insurers, critics say patients are at risk



This week, Missouri transferred the state-run health coverage of about 240,000 low-income adults and children to managed care plans run by three companies: WellCare, Centene Corporation and United Health Group.

The move is part of an increasing privatization of Missouri’s Medicaid program, MO HealthNet. Legislators call it a cost-saving measure that improves efficiency in health care. Critics say the transfer happened too quickly, putting patient health at risk.

The Department of Social Services sent letters and information packets to MO HealthNet enrollees, who were asked to choose one of the plans. If they did not make a selection by April 3, the department auto-enrolled them in one. But many patients reported difficulty figuring out how to fill out the paperwork to pick a plan, and some never received packets at all, said Ryan Barker, director of health policy for the Missouri Foundation for Health.

Patients will have 90 days from May 1 to change plans, but Barker said those who don’t have an appointment scheduled within that time frame may not know their coverage has changed, and won’t have a chance to switch.

State legislatures tend to like managed care, because they can pay contractors a lump sum for the year, and let the insurance companies take on the risk of unexpected health care costs. But the actual cost savings have been modest in Missouri. One review by the consulting firm Mercer suggested savings averaged 1.7 percent between fiscal years 2010 and 2013, or about $27 million a year.

Read more: St. Louis Public Radio

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