Missouri Custom specializes in partnering with employers to address the rising cost of health care through innovative strategies. 

Who We Serve

Missouri Custom is a new, innovative health care program designed for businesses with 50 or more employees in Boone and Cole counties. 

A Collaborative Care Plan

Our innovative approach to health care is designed to improve member satisfaction and the health of the communities we serve. We recognize that when insurance costs increase, employers often find themselves unable absorb the cost – resulting in additional costs to their employees. With that in mind, we’ve developed a program with customizable options that address the rising cost of care. We achieve this by:

• Affordable Care Act-compliant designs
• Lower administrative costs
• Preferred pricing
• Care management

Personalized Plans

We have 11 approved plan designs for groups with less than 100 employees. For groups with more than 100 employees, we will work with you to customize a plan. You can also rest assured knowing that the health of your employees is being coordinated by a local health care leader.

Funding

Missouri Custom allows for alternate funding, level funded, or partially self-funded programs. Our partnership with a lead administrator for turnkey solutions allows employers to be selective in their funding plan.    

Our Network  

Utilizing the combined provider network of University of Missouri Health Care, Capital Region Medical Center and their affiliate physicians, Missouri Custom offers employers access to the largest group of physicians, hospitals and ancillary services in mid-Missouri. This comprehensive care network provides patients with choices to conveniently access care in the setting that best matches their needs, and saves employer’s money by keeping care in-network. Our custom structure allows employers flexibility with TPAs (Third Party Administrators), PBMs (Pharmacy Benefit Manager, and Stoploss (Reinsurance Carriers). We have:

• 1,000+ physicians trained in 60+ specialties and subspecialties
• 7 hospitals
• 90+ clinics
• 600+ beds

Population Health

Missouri Custom uses a care coordination model that is on the forefront of managing the overall health of populations. Our goals are to improve the health of populations, enhance the experience and outcomes of patients, and reduce the cost of care for the benefit of communities. 

Traditional Health Care Model

• Payors pay per service
• Patients are treated for an acute illness
• Care is scattered among various professionals

Our Care Coordination Model

• Payors and employers become our partners, engaging in value-based care
• We help individuals manage their overall health and wellness
• Care is integrated using a highly evolved medical record system and nurse coordinators to foster communication

In a traditional insurance program, the insurance carrier provides medical and disease management.  In our plan, enhanced access to primary care allows the provider to take ownership of the members’ care. That way, the member and the provider are empowered to manage health.  

While traditional networks allow for duplication of services that cost employers money, Missouri Custom incorporates a shared electronic medical record (EMR) – using technology to simplify the health care journey, improve outcomes and reduce duplication of services. 

Using Technology to Better Coordinate Care

Employee onboarding includes assistance establishing care with a primary care provider. This is important because patients with a primary care physician experience:

• Lower overall health care costs
• Better preventive care
• Increased satisfaction with health care 
• Fewer hospitalizations 
• Better management of chronic diseases   

Missouri Custom utilizes state-of-the-art information systems to collect, store, track and analyze employee health data. This allows us to quickly recommend action plans to address potential high-cost health care issues. Chronic conditions can be costly for patients, payors and health systems. Missouri Custom works with employers to identify members at-risk for some of the most common, costly, and preventable health problems including hypertension, diabetes and asthma.

Clinical and Financial Reporting

We believe in transparent reporting. Although traditional reports only incorporate claims data, Missouri Custom incorporates both claims and EMR information to provide a more complete picture of your health care costs.