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MC+ Managed Care Program — Western Region

The Division of Medical Services of the Missouri Department of Social Services contracts with managed care organizations to deliver services through the MC+ Managed Care program. The program is based on a capitated payment made on a per-member, per-month basis in 37 counties in the central, eastern and western regions of the state. Managed care was implemented in the eastern region in September 1995, in the central region in March 1996 and in the western region in January 1997.

Providers are reimbursed on a fee-for-service schedule for services provided to Medicaid-eligible elderly and disabled persons in these counties and for services not included in the MC+ benefit. Recipients in categories of Medical Assistance for Families, Pregnant Women and Children are enrolled in the MC+ program in those regions. More than 344,000 individuals currently are enrolled in the MC+ program. Services are provided through a fee-for-service arrangement in the remaining 78 counties.

Western Region Health Plans — 2007*
Health Plans
Enrollees
Blue Advantage Plus
26,495
Family Health Partners
43,154
HealthCare USA
36,674
Mercy Care Plus
2,917
*enrollment as of June 2007

Western Counties in the MC+ Managed Care Program

Annual MC+ Enrollment — 2000-2007
Western Region of Missouri
2000
2001
2002
2003
2004
2005
2006
2007*
104,465
116,403
126,722
135,890
137,731
119,180
110,654
109,240
Source: Missouri Department of Social Services' Division of Medical Services, State Session MPRI Screen
*enrollment as of June 2007

MC+ Managed Care Program




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