A ‘pathway’ to better Medicaid for Missouri

We live in a country where health care is a constant topic of debate. There are widely varying views on how it should be delivered, how to reduce costs, and how to improve health outcomes. So when the Health Forward team, Kelly Ferrara from StratCommRX and I began the research of identifying preferences among a broad audience – including doctors, consumers, advocates, administrators — on how to improve MO HealthNet (Medicaid in Missouri), we were skeptical we would find much consistency across those preferences.

Our goal was to take preferences from the research and develop a set of recommendations into a one-size fits most pathway to MO HealthNet improvement. The discussions we had with our research participants and the findings we uncovered from the project, A pathway to a reformed and expanded MO HealthNet: Competitive, Accountable and Simplified (or simply The Pathway), were surprisingly refreshing. Many of the individuals and organizations we interviewed had consistent views on what would best meet the needs of those who are served by MO HealthNet. What’s even more refreshing is that these views often times aligned with how consumers of Medicaid in Missouri felt the program could be improved.

Some findings in The Pathway include:

  • The relationship between the client and the provider should be the center of care delivery. To enhance and cultivate this relationship, providers should be incentivized through payments linked to delivering high quality care;
  • Medicaid expansion is integral not just to simplify the MO HealthNet eligibility process, but also to improve the health of all Missourians. Many individuals involved in the project argued that Medicaid expansion – because it gives providers the opportunity to care for more individuals – is critical to the success of the reforms outlined in the The Pathway, especially those targeted toward creating a competitive health care delivery environment.
  • Consumers should have a choice of how to receive their care, and the success of health homes in Missouri should be leveraged to create options for care management for all Medicaid consumers;
  • MO HealthNet is overly complex with barriers to simplified and continuous enrollment; and
  • Accountability should extend to all parties involved in MO HealthNet including consumers, providers, managed care companies and the governmental agencies that oversee the program.

The Pathway aims to shape these findings into actionable steps to increase market competition, consumer choice and accountability at all levels, while implementing simplification measures for a streamlined system. And while the political environment has changed since this research took place, the reforms outlined in The Pathway aim to reduce cost while improving care delivery, health outcomes and program administration, which apply, maybe even more aptly, in times where efforts aim to drastically reduce Medicaid spending.

Editor’s note: In September of 2015, the Health Forward Foundation contracted with StratCommRx and ES Advisors, LLC, to conduct research and get feedback from MO HealthNet stakeholders and consumers. The research and recommendations can be found and downloaded from our website, A pathway to a reformed and expanded MO HealthNet: Competitive, Accountable and Simplified

Health Reform, Policy

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