Patients Accept Incentives for Improvement

Published October 12, 2009

A review of the first two years of West Virginia’s alternative Medicaid program shows some positive results for patients willing to accept incentives to improve their health through personal action.

The report is a performance review of Mountain Health Choices, which replaced West Virginia’s traditional Medicaid program for healthy adults and children in March 2007. The review was conducted through a survey of 1,074 Medicaid recipients by the West Virginia Bureau for Medical Services, with the goal of identifying areas of focus for improvement and future research.

Mountain Health Choices offers two plans—basic and enhanced. Patients are placed on the basic plan by default. To get the enhanced version, which includes expanded prescription drug plans and weight-loss treatments, an applicant must sign a responsibility plan detailing what’s expected of him or her.

The study found adults who selected the enhanced plan were more likely to report having worse health, a higher incidence of obesity, more doctor visits, and more prescriptions per month than those who remained in the basic plan. The differences between children enrolled in the basic and enhanced plans were minimal.

Tami Gurley-Calvez, an assistant professor at West Virginia University’s College of Business and Economics, noted, “It is clear that those on the enhanced plan had worse health and used more services than those on the basic plan.”

Helping Low-Income

According to Dennis Smith, a senior fellow at The Heritage Foundation’s Center for Health Policy Studies in Washington, DC and author of a recent paper, “Health Care Reform in West Virginia: A Lesson from the States,” the new study refutes some misperceptions about Medicaid and shows the positive side of giving people more options.

“The importance of the study is to show that most of the Medicaid population is healthy,” Smith said. “We should be helping low-income individuals. We should help people on Medicaid participate in the rest of the health care system like everyone else.”

“Overall there was a high satisfaction rate,” Gurley-Calvez said.

Smith notes that under the current congressional health care reform legislation, states such as West Virginia would lose much of the flexibility necessary to offer such options to their citizens.

Tabassum Rahmani ([email protected]) writes from Dublin, California.

For more information …

“Health Care Reform in West Virginia: A Lesson from the States,” by Dennis G. Smith, The Heritage Foundation, August 7, 2009: