Other State Access Initiative with Health System Elements

Other State Access Initiatives with Health System Elements

States across the country continue to offer health care reform initiatives. Many of these reform initiatives emphasize wellness and chronic care as well as changing the delivery system. Here are a few examples of what states are doing in these areas.

Indiana Governor Mitch Daniels’s proposal, HB 1680, would create a program to give health insurance to over 100,000 of the state’s residents who have income below 200% FPL and do not have access to employer-based health insurance. Each resident eligible for this program would be able to obtain preventative care capped at $500 per year. The plan would create “personal wellness responsibility” (POWER) accounts, jointly funded by state and participant, to combine with a limited benefit insurance plan capped at $300,000/year, with substantial prevention benefit. This proposal would create a smoking reduction and cessation program focused on decreasing the number of children who smoke and would immunize more children. This plan would be paid for through a cigarette tax increase.

Further details about Governor Daniels’s proposal are available at
http://www.in.gov/apps/utils/calendar/presscal?PF=gov2&Clist=196&Elist=87673
http://www.in.gov/fssa/GovernorsPlan.html

Missouri State Senator Charles Shields has proposed SB 577 , also supported by Governor Matt Blunt, which would replace the state’s Medicaid program with MO Healthnet; the program’s focus would also change from sickness to wellness and prevention. MO Healthnet would also pay providers according to their results, not just for tests and visits.

Pennsylvania Governor Edward Rendell has announced a proposal to cover about 1 million uninsured residents. In addition, this plan would lower costs through reduced hospital infections (Pennsylvania has been a leader in tracking this quality indicator) and expanded roles for nurse practitioners including ER staffing.

More information about Governor Rendell’s proposal is available at
http://www.governor.state.pa.us/governor/cwp/view.asp?a=1113&q=451076&governorNav=|32021|

Minnesota Governor Tim Pawlenty’s proposal would offer MinnesotaCare participants an alternative in the private sector that would emphasize rewarding healthy outcomes. This plan would also establish bonus accounts for MinnesotaCare II enrollees who meet certain preventative care goal; these families would receive $50 per child (for up to 3 children) which would then be put towards offsetting future cost-sharing. In MinnesotaCare Classic, the premiums of children who meet these goals would be reduced by about $4 per month (for up to 3 children in a family). Adults who met these goals for diabetes and cardiac care would also receive this $4 reduction.