Minnesota Health Plan Rate Setting Questioned Due To Disparate Margins & Losses

Minnesota’s managed care rate setting methodology has drawn scrutiny from federal regulators after the state’s four non-profit Medicaid managed care contractors have reported what some analysts consider to be high operating margins on the Medicaid plans, but losses on the health plans funded only with state funds. The managed care contractors include UCare; HealthPartners, Inc.; MHP; and BlueCross Blue Shield of Minnesota (BCBSMN). Minnesota law requires health maintenance organizations to participate in the Medicaid prepaid Medical Assistance program (PMAP) and MinnesotaCare (MNCare) programs as both a condition of licensure and a condition of participating in other plans . . .