Advanced Search


Federal Advocacy
FRA
Grassroots Advocacy
Issues Identification Form
Medicare
MO HealthNet
Political Action Commi­ttees
Regulations
Reports
State Advocacy








Medicaid/MO HealthNet Managed Care Rate Awards

Region
Contract Period
Central
 July 1, 2008 — June 30, 2009
Eastern
 July 1, 2008 — June 30, 2009
Western
 July 1, 2008 — June 30, 2009

Central Region Medicaid Managed Care (MC+) Rate Awards
Contract Period of July 1, 2006 — June 30, 2007

Category of Aid
Mercy CarePlus*
(with pharmacy)
HealthCare USA
(with pharmacy)
Missouri Care
Health Plan
(with pharmacy)
1915B
Infants Under Age 1
$579.80
$579.80
$579.80
Children Ages 1-6
$125.70
$125.70
$125.70
Children Ages 7-13
$101.27
$101.27
$101.27
Female Children Ages 14-20
$299.26
$299.26
$299.26
Male Children Ages 14-20
$121.75
$121.75
$121.75
Females Ages 21-44
$400.43
$400.43
$400.43
Males Ages 21-44
$192.08
$192.08
$192.08
Males and Females Ages 45 and Older
$408.74
$408.74
$408.74
Children in Custody of the Missouri Department of Social Services
Children Ages 0-20
$200.86
$200.86
$200.86
1115B
Children Ages 0-6
$160.99
$160.99
$160.99
Children Ages 7-13
$122.14
$122.14
$122.14
Children Ages 14-18
$175.80
$175.80
$175.80
weighted average rate award per member per month
 
$214.20

*formerly known as Community CarePlus
Source: Office of Administration

Central Region Medicaid Managed Care (MC+) Rate Awards
Contract Period of July 1, 2007 — June 30, 2008

Category of Aid
HealthCare USA
with pharmacy
Mercy CarePlus with pharmacy
Missouri Care
with pharmacy
1915B
Infants Under Age 1
$687.17
$687.17
$687.17
Children Ages 1-6
$143.61
$143.61
$143.61
Children Ages 7-13
$116.00
$116.00
$116.00
Female Children Ages 14-20
$340.24
$340.24
$340.24
Male Children Ages 14-20
$144.98
$144.98
$144.98
Females Ages 21-44
$483.82
$483.82
$483.82
Males Ages 21-44
$230.15
$230.15
$230.15
Males and Females Ages 45 and Older
$470.57
$470.57
$470.57
Children in Custody of the Missouri Department of Social Services' Division of Family Services
Children Ages 0-20
$227.94
$227.94
$227.94
1115B
Children Ages 0-6
$175.25
$175.25
$175.25
Children Ages 7-13
$134.72
$134.72
$134.72
Children Ages 4-18
$193.45
$193.45
$193.45
weighted average rate award
--
--
$249.86

*weighted by member months
Sources: Rates - Office of Administration
115B, 1915B and Children in DFS Custody Member Months — Office of Administration, Division of Purchasing and Material Management

Central Region MO HealthNet Managed Care Rate Awards
Contract Period of July 1, 2008 — June 30, 2009

Category of Aid
HealthCare USA
with pharmacy
Mercy CarePlus with pharmacy
Missouri Care
with pharmacy
1915B
Infants Under Age 1
$806.78
$806.78
$806.78
Children Ages 1-6
$137.38
$137.38
$137.38
Children Ages 7-13
$129.03
$129.03
$129.03
Female Children Ages 14-20
$263.31
$263.31
$263.31
Male Children Ages 14-20
$160.06
$160.06
$160.06
Females Ages 21-44
$399.35
$399.35
$399.35
Males Ages 21-44
$243.05
$243.05
$243.05
Males and Females Ages 45 and Older
$558.69
$558.69
$558.69
Children in Custody of the Missouri Department of Social Services' Division of Family Services
Children Ages 0-20
$248.21
$248.21
$248.21
1115B
Children Ages 0-6
$168.54
$168.54
$168.54
Children Ages 7-13
$138.90
$138.90
$138.90
Children Ages 4-18
$201.19
$201.19
$201.19

All fixed net capitation rates weighted by member months.
Rates provided do not reflect program provisions enacted during the legislative session.
Source: Rates — Office of Administration

Eastern Region Medicaid Managed Care (MC+) Rate Awards
Contract Period of July 1, 2006 — June 30, 2007

Category of Aid
Mercy CarePlus*
(with pharmacy)
Harmony Health Plan of Missouri
(with pharmacy)
HealthCare USA
(with pharmacy)
1915B
Infants Under Age 1
$775.16
$775.16
$775.16
Children Ages 1-6
$112.48
$112.48
$112.48
Children Ages 7-13
$88.57
$88.57
$88.57
Female Children Ages 14-20

$238.11
$238.11
$238.11
Male Children Ages 14-20
$113.12
$113.12
$113.12
Females Ages 21-44
$328.91
$328.91
$328.91
Males Ages 21-44
$169.86
$169.86
$169.86
Males and Females Ages 45 and Older
$392.18
$392.18
$392.18
Children in Custody of the Missouri Department of Social Services
Children Ages 0-20
$201.96
$201.96
$201.96
1115B
Children Ages 0-6
$138.35
$138.35
$138.35
Children Ages 7-13
$106.08
$106.08
$106.08
Children Ages 14-18
$155.92
$155.92
$155.92
weighted average rate award per member per month
 
$196.66

*formerly known as Community CarePlus
Source: Office of Administration

Eastern Region Medicaid Managed Care (MC+) Rate Awards
Contract Period of July 1, 2007 — June 30, 2008

Category of Aid
Harmony Health
with pharmacy
HealthCare USA
with pharmacy
Mercy CarePlus
with pharmacy
1915B
Infants Under Age 1
$863.53
$863.53
$863.53
Children Ages 1-6
$125.55
$125.55
$125.55
Children Ages 7-13
$98.44
$98.44
$98.44
Female Children Ages 14-20
$306.93
$306.93
$306.93
Male Children Ages 14-20
$126.73
$126.73
$126.73
Females Ages 21-44
$418.80
$418.80
$418.80
Males Ages 21-44
$191.64
$191.64
$191.64
Males and Females Ages 45 and Older
$436.77
$436.77
$436.77
Children in Custody of the Missouri Department of Social Services' Division of Family Services
Children Ages 0-20
$233.97
$233.97
$233.97
1115B
Children Ages 0-6
$152.68
$152.68
$152.68
Children Ages 7-13
$117.88
$117.88
$117.88
Children Ages 4-18
$175.38
$175.38
$175.38
weighted average rate award
--
--
$231.48

*weighted by member months
Sources: Rates - Office of Administration
115B, 1915B and Children in DFS Custody Member Months — Office of Administration, Division of Purchasing and Material Management

Eastern Region MO HealthNet Managed Care Rate Awards
Contract Period of July 1, 2008 — June 30, 2009

Category of Aid
Harmony Health
with pharmacy
HealthCare USA
with pharmacy
Mercy CarePlus
with pharmacy
1915B
Infants Under Age 1
$973.00
$973.00
$973.00
Children Ages 1-6
$143.71
$143.71
$143.71
Children Ages 7-13
$111.55
$111.55
$111.55
Female Children Ages 14-20
$216.17
$216.17
$216.17
Male Children Ages 14-20
$135.65
$135.65
$135.65
Females Ages 21-44
$336.54
$336.54
$336.54
Males Ages 21-44
$236.79
$236.79
$236.79
Males and Females Ages 45 and Older
$520.80
$520.80
$520.80
Children in Custody of the Missouri Department of Social Services' Division of Family Services
Children Ages 0-20
$228.75
$228.75
$228.75
1115B
Children Ages 0-6
$167.47
$167.47
$167.47
Children Ages 7-13
$144.64
$144.64
$144.64
Children Ages 4-18
$189.19
$189.19
$189.19

All fixed net capitation rates weighted by member months.
Rates provided do not reflect program provisions enacted during the legislative session.
Source: Rates — Office of Administration

Western Region Medicaid Managed Care (MC+) Rate Awards
Contract Period of July 1, 2006 — June 30, 2007

Category of Aid
Blue Advantage Plus of Kansas City Inc.
(with pharmacy)
Children's Mercy Family Health Partners
(without pharmacy)
Mercy CarePlus*
(with pharmacy)
FirstGuard Health Plan
(with pharmacy)
HealthCare USA
(with pharmacy)
1915B
Infants Under Age 1
$676.31
$654.23
$676.31
$676.31
$676.31
Children Ages 1-6
$124.59
$111.33
$124.59
$124.59
$124.59
Children Ages 7-13
$105.75
$82.83
$105.75
$105.75
$105.75
Female Children Ages 14-20
$263.56
$236.60
$263.56
$263.56
$263.56
Male Children Ages 14-20
$119.71
$95.10
$119.71
$119.71
$119.71
Females Ages 21-44
$349.26
$294.81
$349.26
$349.26
$349.26
Males Ages 21-44
$192.61
$135.94
$192.61
$192.61
$192.61
Males and Females Ages 45 and Older
$394.45
$280.48
$394.45
$394.45
$394.45
Children in Custody of the Missouri Department of Social Services: Jackson County
Children Ages 0-20
$242.64
$142.89
$242.64
$242.64
$242.64
Children in Custody of the Missouri Department of Social Services: Outside Jackson County
Children Ages 0-20
$199.98
$113.26
$199.98
$199.98
$199.98
1115B
Children Ages 0-6
$158.10
$138.72
$158.10
$158.10
$158.10
Children Ages 7-13
$126.84
$97.14
$126.84
$126.84
$126.84
Children Ages 14-18
$169.97
$137.44
$169.97
$169.97
$169.97
weighted average rate award per member per month
 
$208.97
$178.22
$208.97
$208.97
$208.97

*formerly known as Community CarePlus
Source: Office of Administration

Western Region MO HealthNet Managed Care (MC+) Rate Awards
Contract Period of July 1, 2007 — June 30, 2008

Category of Aid
Blue Advantage Plus with pharmacy
Family Health Partners without pharmacy
HealthCare USA with pharmacy
Mercy CarePlus with pharmacy
1915B
Infants Under Age 1
$758.67
$730.07
$758.67
$758.67
Children Ages 1-6
$147.55
$131.22
$147.55
$147.55
Children Ages 7-13
$119.08
$91.72
$119.08
$119.08
Female Children Ages 14-20
$312.64
$279.59
$312.64
$312.64
Male Children Ages 14-20
$149.02
$119.59
$149.02
$149.02
Females Ages 21-44
$469.35
$403.44
$469.35
$469.35
Males Ages 21-44
$229.66
$162.42
$229.66
$229.66
Males and Females Ages 45 and Older
$447.06
$311.78
$447.06
$447.06
Children in Custody of the Missouri Department of Social Services' Division of Family Services in Jackson County
Children Ages 0-20
$284.16
$165.94
$284.16
$284.16
Children in Custody of the Missouri Department of Social Services' Division of Family Services outside Jackson County
Children Ages 0-20
$230.99
$128.33
$230.99
$230.99
1115B
Children Ages 0-6 $177.17
$153.48
 $177.17 $177.17
Children Ages 7-13 $142.71
$107.24
 $142.71 $142.71
Children Ages 4-18 $191.75
$152.81
 $191.75 $191.75

weighted average rate award

$250.53
$213.40
 $250.53 $250.53
*weighted by member months
Sources: Rates - Office of Administration
115B, 1915B and Children in DFS Custody Member Months — Office of Administration, Division of Purchasing and Material Management

Western Region MO HealthNet Managed Care Rate Awards
Contract Period of July 1, 2008 — June 30, 2009

Category of Aid
Blue Advantage Plus without pharmacy
Family Health Partners without pharmacy
HealthCare USA with pharmacy
Mercy CarePlus with pharmacy
1915B
Infants Under Age 1
$765.25
$777.02
$785.53
$785.53
Children Ages 1-6
$149.58
$146.06
$159.40
$159.40
Children Ages 7-13
$106.65
$107.49
$132.07
$132.07
Female Children Ages 14-20
$220.97
$218.62
$243.57
$243.57
Male Children Ages 14-20
$137.63
$136.74
$161.88
$161.88
Females Ages 21-44
$329.68
$324.94
$373.93
$373.93
Males Ages 21-44
$197.07
$194.20
$232.97
$232.97
Males and Females Ages 45 and Older
$383.58
$380.42
$487.89
$487.89
Children in Custody of the Missouri Department of Social Services' Division of Family Services in Jackson County
Children Ages 0-20
$189.06
$189.06
$266.76
$266.76
Children in Custody of the Missouri Department of Social Services' Division of Family Services outside Jackson County
Children Ages 0-20
$138.27
$160.45
$259.83
$259.83
1115B
Children Ages 0-6
$174.62
$171.66
$192.71
$192.71
Children Ages 7-13
$121.63
$119.74
$150.87
$150.87
Children Ages 4-18
$207.10
$199.53
$237.51
$237.51
All fixed net capitation rates weighted by member months.
Rates provided do not reflect program provisions enacted during the legislative session.
Source: Rates — Office of Administration

 

 

 

 


©2003 Missouri Hospital Association, 4712 Country Club Drive, P.O. Box 60, Jefferson City, MO, 65102-0060
Privacy Policy | Site Map | Phone 573/893-3700 | Fax 573/893-2809 | Contact Us

Home | Directories | Employee Background Checks | Hospital Data Services | Convention & Trade Show | Governmental Relations
Law/Regulations| Workforce | Disaster Preparedness| Communications | Education | Health Improvement/Quality | About MHA