Mississippi Today
Medicaid awards managed care contracts after two-year stalemate
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Three companies will begin new contracts to manage the care of Mississippi Medicaid beneficiaries in July of 2025, barring further legal holdups.
For-profit, incumbent companies Magnolia Health and Molina Healthcare and new, nonprofit TrueCare were each awarded four-year, $3.8 billion contracts beginning Aug. 12.
The contracts were stalled for two years – since August 2022 – after two companies that weren’t chosen filed protests with the state alleging that the blind bidding process was unfair and reviewers were not properly blinded to the identities of applicants. The issue is still being litigated in court.
Enrollment in new plans should begin in May 2025, said Mississippi Medicaid spokesperson Matt Westerfield.
The contracts were awarded after Mississippi Medicaid issued one-year emergency contracts last month to Magnolia Health, Molina Healthcare and UnitedHealthcare – the companies currently contracting with the state for managed care services – for the second year in a row, giving new contractors time to implement services.
The state’s managed care program, MississippiCAN, seeks to lower health care costs and improve access to medical services for the state’s most vulnerable citizens, including children, people with disabilities and pregnant women. Beneficiaries of the Children’s Health Insurance Program, which provides low-cost health coverage to children in families that exceed Medicaid’s income ceiling, also receive coordinated care services.
Managed care companies receive per-member payments to maintain a provider network and implement programs intended to improve health outcomes for enrollees.
Nearly three-fourths of the state’s 653,916 Medicaid recipients were enrolled in MississippiCAN services in July 2024.
The effectiveness of managed care programs has been widely debated. Some people argue that managed care companies are incentivized to offer effective preventative care services to members in order to avoid high-cost medical services, while critics argue that their profits are made by denying or limiting services to patients.
Mississippi is one of 40 states that has adopted the managed care organization model for coordinating benefits, according to the National Conference of State Legislatures. The state began its program in 2011.
Mississippi Medicaid has awarded $37.8 billion in state and federally-funded contracts to four managed care companies since 2017.
They represent the largest contracts awarded in the state in at least the last 10 years, according to the state’s contract database.
Magnolia Health, owned by St. Louis-based Centene, has provided managed care services to the state since 2011. In 2021, Centene operated managed care programs in 29 states, according to data from KFF.
Magnolia Health has netted $14.9 billion in contracts from the state since 2017, more than any other managed care company.
California-based Molina Healthcare has provided managed care services to the state since 2017, receiving $8.6 billion in contracts. In 2021, it operated managed care programs in 16 states.
They are some of the most profitable companies in the nation. In 2023, Centene and Molina Healthcare reported nationwide profits of $2.7 billion and $1.1 billion, respectively.
TrueCare is a not-for-profit company established by Mississippi hospitals and the state hospital association to provide an alternative to traditional managed care companies. The company vied for a managed care contract in 2017, but was not selected during the review process.
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Richard Roberson, CEO of TrueCare and incoming president and CEO of the Mississippi Hospital Association, said the goal of the nonprofit is to improve health outcomes for patients and lower care costs.
Because the company is governed by providers, it will be less likely to deny claims and more motivated to use preventative care to avoid costly care, Roberson said.
“I think there is a place for managed care if we’re truly managing care, and not just managing claims,” he said.
Contract controversy
Centene, the company that owns Magnolia Health, settled with the state for $55 million in 2021 amidst an investigation by Attorney General Lynn Fitch and State Auditor Shad White into whether the company inflated prescription drug bills to the Division of Medicaid.
“I do not care how large or powerful the company is, Mississippi taxpayers deserve to get what they paid for when the state spends money on prescription drugs,” said White in a statement at the time.
The company did not admit fault or wrongdoing under the agreement.
The Legislature in 2022 rejected a proposal by Rep. Becky Currie, R-Brookhaven, to prohibit the Division of Medicaid from hiring managed care companies that have settled with the state over allegations of fraud.
“I am for doing away with doing business with a company who took $55 million dollars of our money that was supposed to be spent on the poor, the sick, the elderly, the mentally ill, the disabled,” she said during discussion on the House of Representatives floor.
Magnolia officials at the time said the settlement amount of $55 million did not represent the alleged amount of fees the state was overcharged.
State Medicaid Director Drew Snyder argued the bill could cause a lapse in care for Medicaid beneficiaries and lead to a legal quagmire.
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Centene was one of the largest contributors to Gov. Tate Reeves’ gubernatorial campaign in 2023. The company and its political action committee (PAC) have donated $370,000 to Reeves since 2010. It has also donated to many state legislators’ campaigns, according to public documents on the Secretary of State’s website.
A standoff
The contract selection process itself also attracted scrutiny.
Mississippi Medicaid began seeking new contracts for managed care in December 2021, with plans to begin the contracts in July 2023. The division’s “request for qualifications” yielded five responses.
The agency announced its selection of Magnolia Health, Molina Healthcare and TrueCare in August 2022.
A protracted legal battle began one week later when the two companies that weren’t chosen – Amerigroup and UnitedHealthcare – cried foul, arguing that the selection process was unfair.
The review process used a blind bidding process to evaluate applications while keeping the identities of the companies hidden.
The companies argued the state failed to properly “blind” contract evaluators to the identities of applicants by allowing companies to include identifying information in their application.
“Protests in state Medicaid managed care procurements are a near certainty,” Medicaid spokesperson Matt Westerfield told Mississippi Today in an email. “… It’s just become part of doing business for the companies that don’t win.”
The Division of Medicaid denied the protests in June 2023. The Public Procurement Review Board, the body responsible for reviewing contract acquisition processes, denied a subsequent appeal in April 2024.
The Public Procurement Review Board ruled that the Division of Medicaid properly carried out blind scoring procedures.
Amerigroup and UnitedHealthcare turned to the courts in April and May, respectively, when they sued the Division of Medicaid and the Public Procurement Review Board, aiming to halt the contracts from being awarded.
Westerfield acknowledged that the court’s adjudication process could alter the state’s plan to begin the new contracts in July 2025, but said the division did not expect any delays.
Minnesota-based UnitedHealth Group, which owns UnitedHealthcare, currently provides managed care services to Mississippi Medicaid beneficiaries. It generates more money than any other U.S. health care company, according to Becker’s Hospital Review. In 2023, the company reported $23.1 billion in net earnings. It provided managed care services to 26 states in 2021.
In the state’s 2023 external audit of managed care organizations, UnitedHealthcare met 98% of standards for MississippiCAN. Magnolia met 97% and Molina met 92%.
Amerigroup has not held a contract for managed care service in Mississippi. It is owned by Minneapolis-based Elevance Health.
Magnolia Health, Molina Healthcare and UnitedHealthcare did not respond to requests for comment for this story.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1898
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Feb. 22, 1898
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Frazier Baker, the first Black postmaster of the small town of Lake City, South Carolina, and his baby daughter, Julia, were killed, and his wife and three other daughters were injured when a lynch mob attacked.
When President William McKinley appointed Baker the previous year, local whites began to attack Baker’s abilities. Postal inspectors determined the accusations were unfounded, but that didn’t halt those determined to destroy him.
Hundreds of whites set fire to the post office, where the Bakers lived, and reportedly fired up to 100 bullets into their home. Outraged citizens in town wrote a resolution describing the attack and 25 years of “lawlessness” and “bloody butchery” in the area.
Crusading journalist Ida B. Wells wrote the White House about the attack, noting that the family was now in the Black hospital in Charleston “and when they recover sufficiently to be discharged, they) have no dollar with which to buy food, shelter or raiment.
McKinley ordered an investigation that led to charges against 13 men, but no one was ever convicted. The family left South Carolina for Boston, and later that year, the first nationwide civil rights organization in the U.S., the National Afro-American Council, was formed.
In 2019, the Lake City post office was renamed to honor Frazier Baker.
“We, as a family, are glad that the recognition of this painful event finally happened,” his great-niece, Dr. Fostenia Baker said. “It’s long overdue.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Memorial Health System takes over Biloxi hospital, what will change?
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by Justin Glowacki with contributions from Rasheed Ambrose, Javion Henry, McKenna Klamm, Matt Martin and Aidan Tarrant
BILOXI – On Feb. 1, Memorial Health System officially took over Merit Health Biloxi, solidifying its position as the dominant healthcare provider in the region. According to Fitch Ratings, Memorial now controls more than 85% of the local health care market.
This isn’t Memorial’s first hospital acquisition. In 2019, it took over Stone County Hospital and expanded services. Memorial considers that transition a success and expects similar results in Biloxi.
However, health care experts caution that when one provider dominates a market, it can lead to higher prices and fewer options for patients.
Expanding specialty care and services
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One of the biggest benefits of the acquisition, according to Kristian Spear, the new administrator of Memorial Hospital Biloxi, will be access to Memorial’s referral network.
By joining Memorial’s network, Biloxi patients will have access to more services, over 40 specialties and over 100 clinics.
“Everything that you can get at Gulfport, you will have access to here through the referral system,” Spear said.
One of the first improvements will be the reopening of the Radiation Oncology Clinic at Cedar Lake, which previously shut down due to “availability shortages,” though hospital administration did not expand on what that entailed.
“In the next few months, the community will see a difference,” Spear said. “We’re going to bring resources here that they haven’t had.”
Beyond specialty care, Memorial is also expanding hospital services and increasing capacity. Angela Benda, director of quality and performance improvement at Memorial Hospital Biloxi, said the hospital is focused on growth.
“We’re a 153-bed hospital, and we average a census of right now about 30 to 40 a day. It’s not that much, and so, the plan is just to grow and give more services,” Benda said. “So, we’re going to expand on the fifth floor, open up more beds, more admissions, more surgeries, more provider presence, especially around the specialties like cardiology and OB-GYN and just a few others like that.”
For patient Kenneth Pritchett, a Biloxi resident for over 30 years, those changes couldn’t come soon enough.
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Pritchett, who was diagnosed with congestive heart failure, received treatment at Merit Health Biloxi. He currently sees a cardiologist in Cedar Lake, a 15-minute drive on the interstate. He says having a cardiologist in Biloxi would make a difference.
“Yes, it’d be very helpful if it was closer,” Pritchett said. “That’d be right across the track instead of going on the interstate.”
Beyond specialty services and expanded capacity, Memorial is upgrading medical equipment and renovating the hospital to improve both function and appearance. As far as a timeline for these changes, Memorial said, “We are taking time to assess the needs and will make adjustments that make sense for patient care and employee workflow as time and budget allow.”
Unanswered questions: insurance and staffing
As Memorial Health System takes over Merit Health Biloxi, two major questions remain:
- Will patients still be covered under the same insurance plans?
- Will current hospital staff keep their jobs?
Insurance Concerns
Memorial has not finalized agreements with all insurance providers and has not provided a timeline for when those agreements will be in place.
In a statement, the hospital said:
“Memorial recommends that patients contact their insurance provider to get their specific coverage questions answered. However, patients should always seek to get the care they need, and Memorial will work through the financial process with the payers and the patients afterward.”
We asked Memorial Health System how the insurance agreements were handled after it acquired Stone County Hospital. They said they had “no additional input.”
What about hospital staff?
According to Spear, Merit Health Biloxi had around 500 employees.
“A lot of the employees here have worked here for many, many years. They’re very loyal. I want to continue that, and I want them to come to me when they have any concerns, questions, and I want to work with this team together,” Spear said.
She explained that there will be a 90-day transitional period where all employees are integrated into Memorial Health System’s software.
“Employees are not going to notice much of a difference. They’re still going to come to work. They’re going to do their day-to-day job. Over the next few months, we will probably do some transitioning of their computer system. But that’s not going to be right away.”
The transition to new ownership also means Memorial will evaluate how the hospital is operated and determine if changes need to be made.
“As we get it and assess the different workflows and the different policies, there will be some changes to that over time. Just it’s going to take time to get in here and figure that out.”
During this 90-day period, Erin Rosetti, Communications Manager at Memorial Health System said, “Biloxi employees in good standing will transition to Memorial at the same pay rate and equivalent job title.”
Kent Nicaud, President and CEO of Memorial Health System, said in a statement that the hospital is committed to “supporting our staff and ensuring they are aligned with the long-term vision of our health system.”
What research says about hospital consolidations
While Memorial is promising improvements, larger trends in hospital mergers raise important questions.
Research published by the Rand Corporation, a nonprofit, nonpartisan research organization, found that research into hospital consolidations reported increased prices anywhere from 3.9% to 65%, even among nonprofit hospitals.
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The impact on patient care is mixed. Some studies suggest merging hospitals can streamline services and improve efficiency. Others indicate mergers reduce competition, which can drive up costs without necessarily improving care.
When asked about potential changes to the cost of care, hospital leaders declined to comment until after negations with insurance companies are finalized, but did clarify Memorial’s “prices are set.”
“We have a proven record of being able to go into institutions and transform them,” said Angie Juzang, Vice President of Marketing and Community Relations at Memorial Health System.
When Memorial acquired Stone County Hospital, it expanded the emergency room to provide 24/7 emergency room coverage and renovated the interior.
When asked whether prices increased after the Stone County acquisition, Memorial responded:
“Our presence has expanded access to health care for everyone in Stone County and the surrounding communities. We are providing quality healthcare, regardless of a patient’s ability to pay.”
The response did not directly address whether prices went up — leaving the question unanswered.
The bigger picture: Hospital consolidations on the rise
According to health care consulting firm Kaufman Hall, hospital mergers and acquisitions are returning to pre-pandemic levels and are expected to increase through 2025.
Hospitals are seeking stronger financial partnerships to help expand services and remain stable in an uncertain health care market.
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Source: Kaufman Hall M&A Review
Proponents of hospital consolidations argue mergers help hospitals operate more efficiently by:
- Sharing resources.
- Reducing overhead costs.
- Negotiating better supply pricing.
However, opponents warn few competitors in a market can:
- Reduce incentives to lower prices.
- Slow wage increases for hospital staff.
- Lessen the pressure to improve services.
Leemore Dafny, PhD, a professor at Harvard and former deputy director for health care and antitrust at the Federal Trade Commission’s Bureau of Economics, has studied hospital consolidations extensively.
In testimony before Congress, she warned: “When rivals merge, prices increase, and there’s scant evidence of improvements in the quality of care that patients receive. There is also a fair amount of evidence that quality of care decreases.”
Meanwhile, an American Hospital Association analysis found consolidations lead to a 3.3% reduction in annual operating expenses and a 3.7% reduction in revenue per patient.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Adopted people face barriers obtaining birth certificates. Some lawmakers point to murky opposition from judges
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When Judi Cox was 18, she began searching for her biological mother. Two weeks later she discovered her mother had already died.
Cox, 41, was born in Gulfport. Her mother was 15 and her father didn’t know he had a child. He would discover his daughter’s existence only when, as an adult, she took an ancestry test and matched with his niece.
It was this opaque family history, its details coming to light through a convergence of tragedy and happenstance, that led Cox to seek stronger legal protections for adopted people in Mississippi. Ensuring adopted people have access to their birth certificates has been a central pillar of her advocacy on behalf of adoptees. But legislative proposals to advance such protections have died for years, including this year.
Cox said the failure is an example of discrimination against adopted people in Mississippi — where adoption has been championed as a reprieve for mothers forced into giving birth as a result of the state’s abortion ban.
“A lot of people think it’s about search and reunion, and it’s not. It’s about having equal rights. I mean, everybody else has their birth certificate,” Cox said. “Why should we be denied ours?”
Mississippi lawmakers who have pushed unsuccessfully for legislation to guarantee adoptees access to their birth certificate have said, in private emails to Cox and interviews with Mississippi Today, that opposition comes from judges.
“There are a few judges that oppose the bill from what I’ve heard,” wrote Republican Sen. Angela Hill in a 2023 email.
Hill was recounting opposition to a bill that died during the 2023 legislative session, but a similar measure in 2025 met the same fate. In an interview this month, Hill said she believed the political opposition to the legislation could be bound up with personal interest.
“Somebody in a high place doesn’t want an adoption unsealed,” Hill said. “I don’t know who we’re protecting from somebody finding their birth parents,” Hill said. “But it leads you to believe some people have a very strong interest in keeping adoption records sealed. Unless it’s personal, I don’t understand it.”
In another 2023 email to Cox reviewed by Mississippi Today, Republican Rep. Lee Yancey wrote that some were concerned the bill “might be a deterrent to adoption if their identities were disclosed.”
The 2023 legislative session was the first time a proposal to guarantee adoptees access to their birth certificates was introduced under the state’s new legal landscape surrounding abortion.
In 2018, Mississippi enacted a law that banned most abortions after 15 weeks. The state’s only abortion clinic challenged the law, and that became the case that the U.S. Supreme Court used in 2022 to overturn Roe v. Wade, its landmark 1973 ruling that established a nationwide right to abortion.
Roe v. Wade had rested in part on a woman’s right to privacy, a legal framework Mississippi’s Solicitor General successfully undermined in Dobbs v. Jackson Women’s Health Organization. Before that ruling, anti-abortion advocates had feared allowing adoptees to obtain their birth certificates could push women toward abortion rather than adoption.
Abortion would look like a better option for parents who feared future contact or disclosure of their identities, the argument went. With legal access to abortion a thing of the past in Mississippi, Cox said she sees a contradiction.
“Mississippi does not recognize privacy in that matter, as far as abortions and all that. So if you don’t acknowledge it in an abortion setting, how can you do it in an adoption setting?” Cox said. “You can’t pick and choose whether you’re going to protect my privacy.”
Opponents to legislation easing access to birth certificates for adoptees have also argued that such proposals would unfairly override previous affidavits filed by birth parents requesting privacy.
The 2025 bill, proposed by Republican Rep. Billy Calvert, would direct the state Bureau of Vital Records to issue adoptees aged 21 and older a copy of their original birth certificate.
The bill would also have required the Bureau to prepare a form parents could use to indicate their preferences regarding contact from an adoptee. That provision, along with existing laws that guard against stalking, would give adoptees access to their birth certificate while protecting parents who don’t wish to be contacted, Cox said.
In 2021, Cox tried to get a copy of her birth certificate. She asked Lauderdale County Chancery Judge Charlie Smith, who is now retired, to unseal her adoption records. The Judge refused because Cox had already learned the identity of her biological parents, emails show.
“With the information that you already have, Judge Smith sees no reason to grant the request to open the sealed adoption records at this time,” wrote Tawanna Wright, administrator for the 12th District Chancery Court in Meridian. “If you would like to formally file a motion and request a hearing, you are certainly welcome to do so.”
In her case and others, judges often rely on a subjective definition of what constitutes a “good cause” for unsealing records, Cox said. Going through the current legal process for unsealing records can be costly, and adoptees can’t always control when and how they learn the identity of their biological parents, Cox added.
After Cox’s biological mother died, her biological uncle was going through her things and came across the phone number for Cox’s adoptive parents. He called them.
“My adoptive mom then called to tell me the news — just hours after learning I was expecting my first child,” Cox said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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