Missouri
The Missouri Health Improvement Act of 2007 included a provision that the Department of Social Services should create health improvement plans for all participants in MO HealthNet to include coordinated care plans and be enrolled in a health care home. The Missouri Foundation for Health launched the Advancing Chronic Care through Excellence in Systems and Support (ACCESS) program in 2010, designed to improve the delivery of chronic illness care. ACCESS works with Federally Qualified Health Centers (FQHC), local Health Departments, hospitals, and academic health centers through a learning collaborative model to improve team care and care coordination. In 2011, Missouri was awarded the first approved State Plan Amendment (SPA) to implement their Section 2703 Health Homes program. To accelerate the transformation to a Health Home model, the Missouri Foundation for Health and the Healthcare Foundation of Greater Kansas City funded an 18-month Learning Collaborative for behavioral health and primary care teams.
Primary Care Innovations and PCMH Activity
| Dual Eligible | 2703 SPA | CPC | CPC+ | PCMH QHP | PCMH Legislation | Private Payer |
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Multi-Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| Greater Kansas City-Missouri Comprehensive Primary Care Plus | Multi-Payer | Johnson County, KS; Wyandotte County, KS; Clay County, MO; Jackson County, MO; Platte County, MO | CMS Comprehensive Primary Care Plus (CPC+) |
   
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Public Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| CMS Health Care Innovation Award - The Curators of the University of Missouri | Grant | University of Missouri Health System | CMS Health Care Innovation Award (Round 1) | |
| Coordinating All Resources Effectively (CARE) - Missouri | Grant | California, Colorado, Florida, Missouri, Pennsylvania, Texas, Ohio | CMS Health Care Innovation Award (Round 2) |
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| Missouri Health Homes Program | Medicaid | Statewide | ACA Section 2703 Health Homes |
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Private Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| Blue KC medical home | Commercial | Greater Kansas City area | ||
| Cigna and St. John's Mercy Medical Group Collaborative Accountable Care Pilot Program | Commercial | St. Louis metro area | Cigna Collaborative Care Program | |
| Enhanced Personal Health Care Program - Missouri | Commercial | all counties where Anthem operates | Anthem - Enhanced Personal Health Care |
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| Meritas Health Corporation and Cigna Accountable Care Program | Commercial | Kansas City | Cigna Collaborative Care Program | |
| UnitedHealthcare Patient-Centered Medical Home Program- Missouri | Commercial | Kansas City | UnitedHealthcare PCMH Program |
State Legislation
| Legislation | Status | Year |
|---|---|---|
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Missouri Health Improvement Act of 2007 The Act included a provision that the Department of Social Services should create health improvement plans for all participants in MO HealthNet to include coordinated care plans and be enrolled in a health care home. |
Enacted | 2007 |
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HB 879: Primary Care Transparency Act This bill establishes the Primary Care Transparency Act, which requires all health insurance carriers to report to the Director of the Department of Insurance, Financial Institutions and Professional Registration (DIFP) their total health care medical expenditures and their total primary care medical expenditures for the year by March 1st each year. By March 31st each year, the DIFP must submit a report to the General Assembly. All individual patient data reported under these provisions is confidential and must be reported in the aggregate. |
Pending | 2019 |
State Facts:
Population:
6,005,100
Uninsured Population:
11%
Total Medicaid Spending FY 2013:
$9.0 Billion
Overweight/Obese Adults:
65.5%
Poor Mental Health among Adults:
32.3%
Medicaid Expansion:
No
News and Events
June 19, 2018 | Forbes
September 14, 2016
August 28, 2015 | The Missouri Times
May 14, 2015 | Ozarks First
