A major change in Missouri Medicaid has been approved by the legislature. And the two architects of the change predict a better, more cost-effective program will be the result.
Medicaid, as we know it, is slated to end. MO Health Net begins. The new program emphasizes prevention and contains aspects of managed care in an effort to control costs.
Costs will go up for provider reimbursement, which Rep. Rob Schaaf (R-St. Joseph) sees as the key to lure specialists back into the program. Schaaf, the House sponsor, says access to Medicaid has been hindered because of low reimbursements. He says that has kept many doctors from participating in the program, in particular specialists.
How much reimbursement will rise depends on the state budget. The MO Health Net bill, SB 577 , proposes a five-year plan to increase provider reimbursements. It creates a Joint Committee on MO Health Net to review budget figures and project costs.
Costs can be controlled, according to Sen. Charlie Shields (R-St. Joseph), but only by so much. Shields says Medicaid, now MO Health Net, is not a program that will cost less next year than it did this year. Shields says the best the General Assembly can do is the slow the growth of the program.
One idea pushed by Shields and Governor Blunt didn’t make it into the bill: a rewards debit card. The idea was to give recipients rewards for healthy choices that could be used to purchase additional services. Shields points out that while the idea didn’t make it into the bill, it isn’t dead. He says the Department of Social Services could still consider the idea when it works on the details of MO Health Net.
Many of the details of the new program will be hammered out by the Department of Social Services. The bill approved by the legislature this year created an oversight committee that will both guide and review the department’s work.