Michigan Offers Lifestyle Incentives for Medicaid Recipients

Published June 1, 2007

If Michigan Medicaid recipients start leading healthier lifestyles, they could be rewarded with care benefits as a way to help the state control health care costs, if a plan the state Senate approved at the end of February gets the go-ahead from the state House of Representatives and governor.

The Senate passed the bill 37-0 on February 22, referring it to the House Health Policy Committee.

State sen. Tom George (R-Kalamazoo), the measure’s sponsor, said he is interested in getting not just Medicaid recipients but all Michigan residents to lead healthier lives.

“Everyone needs a health care policy that rewards good behavior,” George said.

Increasing Costs

Medicaid is the fastest-growing category in Michigan’s state budget, George said–and it has increased 40 percent over the past four years.

“Our Medicaid recipients tend to have worse health,” George said. About 23 percent of adults in Michigan smoke, and about 44 percent of the state’s adult Medicaid recipients do so. According to the American Heart Association, studies show cigarette smokers are at higher risk of heart attack and stroke and are at least twice as likely to die from coronary heart disease as are nonsmokers.

When people aren’t living healthy lives, they can pose a financial burden on the state budget and also on local government, schools, and business, George said. General Motors, the state’s largest employer, now spends more on health care than on steel, he noted. Those expenses are passed on to consumers–a GM car costs $1,500 more than it used to, he said.

Creating Incentives

George favors creating incentives–among them expanded benefits and lower co-payments–to reward Medicaid recipients for maintaining healthy lifestyles. The Department of Community Health would specify rewardable behaviors under the Senate bill, which might include participating in health risk assessments and screenings, attending scheduled doctors’ appointments, and participating in smoking-cessation programs.

George said a patient who tries to get good prenatal care could be rewarded with dental benefits. He said he wants to emphasize preventive health measures.

“It’s easy to procrastinate” over going to the doctor until a patient needs more expensive “repair work,” George said, whereas preventing problems through regular check-ups saves the state money.

Motivating People

Though it’s not always possible for Medicaid recipients to exercise outside, and although it can be difficult to verify they’ve been exercising at all, it is easy to have their cholesterol levels and blood pressure checked.

“Anything that we can do to motivate people to go on a heart-healthy diet” and eat more fruits and vegetables is a good idea, said Dr. Richard Stein, director of preventive cardiology at the Beth Israel Medical Center in New York City.

Although Stein said people don’t like having “Big Brother is watching you” laws, “any way you can motivate” people to start leading healthier routines is good–a point free-market analysts have long said will cut public health care costs.

“Once you’ve gotten people on the first few steps toward heart-healthy living,” Stein said, most people tend to motivate themselves into sticking with it and going further.

Mary Susan Littlepage ([email protected]) writes from Chicago.

For more information …

Senate Bill 1, by state Sen. Tom George (R-Kalamazoo), http://www.michiganvotes.org/2007-SB-1

Background on WEYCO Inc.’s Tobacco-Free Policy, www.weyco.com/web/company/news/012520050001.jsp;jsessionid=432842bf9b72447b69661b9bde839113