Mississippi Coordination Access Network (MississippiCAN)

Program Location: 
Jackson, MS
Payer Type: 
Medicaid
Payers: 
Medicaid
Magnolia Health Plan
UnitedHealthcare Community Plan
Description: 

The Mississippi Coordination Access Network (MississippiCAN) is a Coordinated Care Program for Mississippi Medicaid beneficiaries.  The program is designed to:

  • Improve access to needed medical services - This goal will be accomplished by connecting the targeted beneficiaries with a medical home, increasing access to providers and improving beneficiaries’ use of primary and preventive care services.
  • Improve quality of care – This goal will be accomplished by providing systems and supportive services, including disease state management and other programs that will allow beneficiaries to take increased responsibility for their health care.
  • Improve efficiencies and cost effectiveness – This goal will be accomplished by contracting with Coordinated Care Organizations (CCOs) on a full-risk capitated basis to provide comprehensive services through an efficient, cost effective system of care

The CCOs are expected to participate as partners, with providers and beneficiaries, in arranging the delivery of health care services that improve health status in a cost-effective way. DOM expects CCOs to connect beneficiaries to a medical home and implement comprehensive care management programs for the populations. Care management includes a method to coordinate services with behavioral health providers, social services agencies, and out-of-state providers to improve care and quality outcomes. CCOs are required to have a disease management program that focuses on diseases that are chronic or very high cost, including but not limited to diabetes, asthma, hypertension, obesity, congestive heart disease, organ transplants, and improved birth outcomes.

During the 2012 Legislative Session, House Bill 421 was passed which authorized certain changes to the program that included increasing from 15% to 45% the percentage of Medicaid beneficiaries who can be enrolled in coordinated care program.

 

Payment Model: 

CCOs receive a prepaid monthly capitated payment and provide services through a full-risk arrangement

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