Missouri Medicaid Managed Care Contracts

Missouri has three health plans operating statewide, and individuals have a choice of plan. The contracts are available for download:

Home State Health Plan, Inc.
Missouri Care, Inc.
United Healthcare of the Midwest, Inc.

The Medicaid managed care contracts include a performance withhold of 5% of the capitation rate. The withhold is returned based on performance on five indicators. A return of up to 1% of the capitation rate is possible for each indicator. The categories are as follows:

Encounter data completeness and accuracy
Provider panel directory completeness/accuracy
Healthy children and youth/EPSDT participant ratio
Case management
Medicaid reform . . .