Kansas Medicaid members could face a preferred drug list and a streamlined prior authorization process, which could widen the number of therapeutic classes the state covers. These changes are borne out of budgets cuts expected for next year. MO HealthNet, Missouri's Medicaid program, has approved the entrance of Aetna's Missouri Care into two new managed care regions, setting up a more competitive environment in the Kansas City- and St. Louis-centered regions, as well as setting the stage for competition down the road. Aetna's unique partnership in Heartland Health, using the former Community Health Plan's wellness program and data analysis tools, could represent a model for a more inegrated approach with providers in smaller metropolitan regions.