Minnesota Medicaid MCO Performance Scorecard (8 Plans)

Name: Minnesota Medicaid MCO Performance Scorecard (8 Plans)
Creator: Minnesota Medicaid Transparency Project
Published: 2026-03-14
License: https://creativecommons.org/licenses/by/4.0/

Author: Minnesota Medicaid Transparency Project | Last updated: March 12, 2026

Ranking Minnesota's 8 Medicaid MCOs on claims processing, grievance rates, network adequacy, and workforce compensation metrics.

Data Overview

Total Mcos: 8
Total Enrollment: 1260000
Measurement Year: 2023
Note: Medicaid-specific performance metrics derived from DHS contract reports, CMS T-MSIS data, HEDIS Medicaid measures, and MCO annual filings. Star ratings on the NCQA site reflect all lines of business — these metrics isolate Medicaid managed care performance.

Key Findings

HealthPartners ranks #1 on Medicaid-specific performance despite having only 7.4% market share — fastest claims processing (12.1 days), lowest grievance rate (3.2/1K), and highest network adequacy (95.6%).
Medica, which acquired UCare in 2025, ranks #7 with the highest grievance rate (6.4/1K), slowest encounter data submission (41 days), and highest voluntary disenrollment (8.9%) among statewide plans.
County-based MCOs average 28% more ED visits (605 vs 474 per 1K) and 17% higher readmission rates (13.3% vs 11.4%) than statewide nonprofits — reflecting rural access challenges, not necessarily worse management.
South Country Health Alliance has the lowest overall Medicaid score (52) driven by the weakest network adequacy (82.1%), highest ED visits (612/1K), and most incomplete encounter data (87.3%).
Encounter data completeness ranges from 87.3% (South Country) to 97.2% (HealthPartners) — a 10-point gap that directly impacts DHS's ability to detect fraud and monitor care quality.
Statewide MCO compensation data (HealthPartners, Blue Plus, UCare, Medica) cannot be compared to DHS or county staff because their public filings report total-organization figures across commercial, Medicare, and Medicaid lines — no Medicaid-specific workforce breakdown exists. County-based MCOs, which are Medicaid-only, pay an average of $101,750 — 8% more than DHS ($94,500) and 16% more than county Medicaid staff ($88,000). County-based MCO executive comp averages $267K, compared to $185K at DHS.

Part of the Minnesota Medicaid Transparency Project — an independent, data-driven investigation of $23 billion in annual Medicaid spending across 87 counties.

Key Topics

Minnesota Medicaid Fraud — Medicaid fraud in Minnesota — $400M+ prosecuted since 2005, 14 high-risk programs, 87 county oversight gaps, and zero centralized fraud dete...
Medicaid Spending Minnesota — How Minnesota spends $23B on Medicaid — per-enrollee costs, disability spending (#1 nationally), program growth, and managed care payments.
Medicaid Oversight Minnesota — How Minnesota oversees $23B in Medicaid — DHS oversight structure, audit failures, workforce gaps, and the 37:1 expansion-to-oversight ratio...
Medicaid Fraud Cases Minnesota — Prosecuted Medicaid fraud cases in Minnesota — Feeding Our Future, PCA fraud, EIDBI billing schemes, 245D provider abuse, and settlement out...
Which States Have Most Medicaid Fraud — How Minnesota compares on Medicaid fraud risk — per-enrollee spending rankings, oversight gaps, and systemic vulnerability factors by state.