Missouri's Medicaid program is preparing to centralize management of pharmaceutical benefits for some 850,000 beneficiaries across the state. Previously, managed care plans managed the pharmacy and medical benefits for enrollees, but that will change as of October 2009 when the state also implements new contracts for winning MCOs in that state. Budget problems in Kansas, meanwhile, are jeopardizing a care management program in Wichita that has saved significant dollars despite its low enrollment. A drug commonly known as 17P is being used by Coventry Heath Care and Molina Healthcare – two Missouri Medicaid HMOs – to reduce the number of premature births. Stock market losses have cut into the earnings of the region's two large nonprofit Blue Cross Blue Shield plans, but underwriting gains were large enough to keep the plans on positive financial footing for 2008. The Kansas State Employee Health Benefits Plan is tightening up controls on popular brand-name drug classes in an effort to reduce costs. And Medicare private fee-for-service plans are evaluating their options ahead of the deadline in 2011 for converting products in many of their geographies into network-based Medicare Advantage products.