Missouri Medicaid System: An OPEN MINDS State Profile

This highly-detailed report provides a deep-dive into Missouri’s Medicaid program. Each state Medicaid program is unique and the population’s served, benefit package, and the financing and service delivery systems differ. This report contains the information needed to inform strategic decisionmaking and evaluate new opportunities. Published in September 2018, this report includes information on:

1. Medicaid Governance & Leadership – A chart showing how Missouri’s Medicaid system is organized and the key players at the Medicaid department.
2. Medicaid Program Spending – Detailed information on state Medicaid spending line items, spending over time, and per enrollee spending compared to the national average.
3. Medicaid Financing & Service Delivery – A close look at Missouri’s Medicaid financing system, the population covered, and benefit package.
4. Health Plan Characteristics – A review of the Medicaid health plans including their market share, where they operate, and whether they subcontract with a pharmacy benefit manager and/or behavioral health organization.
5. Care Coordination Initiatives – Detailed information on state health home, accountable care organizations, and other relevant programs that are designed to improve care coordination and care delivery for enrollees.
6. Pending Changes To Medicaid System – A clear timeline of the changes Missouri plans to make over the next five years and any long-term initiatives that have been proposed.
7. Medicaid Demonstration & HCBS Waivers – A list of demonstration waivers and their key components effecting financing and delivery systems for enrollees. Additional information on state home- and community-based services (HCBS) waivers including waiver management, enrollment caps, and eligible populations.
8. Additional Information For Further Research- Each profile contains a glossary of key terms and a detailed list of sources to allow readers to conduct their own research and go right to the source for additional information.