States May Offer
Financial Rewards to Medicaid Patients to Adopt Healthier Lifestyle
HHS approves $100
million in effort to stem the growth of chronic health conditions
March 1, 2011 -
Senior citizens relying on the Medicaid program for medical care may
soon be offered a financial incentive to persuade them to adopt
healthier behavior, such as quitting smoking or losing weight. Last week
Health and Human Services said it is offering $100 million to states for
this purpose.
The HHS
announcement said this if part of the government’s efforts to prevent an
increase in the number of people with chronic health conditions.
“Keeping people
healthy is an important goal of the Affordable Care Act,” said HHS
Secretary Kathleen Sebelius. “One way to reach that goal is to
encourage all Americans to make better choices about diet, exercise and
smoking to avoid potentially disastrous outcomes down the road like
heart disease, cancer or diabetes.”
Editor’s Note: Enrollment in the state-federal
program that is often the last resort safety net for chronically ill
senior citizens rose by 8.5 percent in fiscal year 2010
This report by Statline.org, published November 26,
explains the health care crisis faced by many states as more of the
burden for Medicaid, SCHIP move to them
Under the Act,
states may apply to the Centers for Medicare & Medicaid Services (CMS)
for grants to fund programs that demonstrate changes in health risk and
outcomes, including the adoption of healthy behaviors.
The HHS
announcement said, “One way to encourage difficult changes in life
habits such as overeating or smoking, research has shown, is to offer
economic incentives to those who reach stated goals. With that in mind,
CMS will encourage states to adopt such strategies as rewarding Medicaid
enrollees who meet goals established for them such as weight loss,
smoking cessation or diabetes prevention or control.”
Rewards could
range from direct cash incentives, gift cards to grocery stores or other
retailers, reduced Medicaid program fees (if any apply) or offering
services not normally available through Medicaid.
“With the right
incentives, we believe that people can change their behaviors and stop
smoking or lose weight,” said CMS Administrator Donald Berwick, M.D.
“Not only can
preventive programs help to improve individuals’ health, by keeping
people healthy we can also lower the nation’s overall health care
costs.”The program focuses on those behaviors that can cause some of the
most critical chronic conditions that together affect millions of
Americans for example:
● Tobacco use
is responsible for more than 430,000 deaths each year, and is the
largest cause of preventable morbidity and mortality in the U.S.
Although rates have declined over the past decades, roughly one in five
high school students and adults smoke cigarettes. Also, for every
person who dies from a smoking-related disease, about 20 more people
have at least one serious illness related to smoking.
● Overweight
and obesity have been shown to increase the likelihood of certain
diseases and other health problems, and are important concerns for
adults, children, and adolescents in the U.S. An estimated 26.7
percent of adults in the U.S. reported being obese in 2009, up 1.1
percentage points since 2007, and approximately 300,000 deaths per year
may be attributable to obesity. In 2008, the annual healthcare cost of
obesity in the U.S. was estimated to be as high as $147 billion a year.
● More than
one-third of adults have two or more of the major risk factors for heart
disease, a leading cause of morbidity, mortality, and health care
utilization and spending.
● Diabetes is
the seventh leading cause of death in the U.S. and accounted for $116
billion in total U.S. healthcare system costs in 2007, and almost 24
million Americans have diabetes, including 5.7 million who don’t know
they have the disease. Also about 186,300 people younger than 20 years
have Type 1 or Type 2 diabetes.
Research in the
field, largely based on commercial insurance program experience, has
shown that financial incentives can be effective in the short run for
simple preventive care and distinct behavioral goals, but this
demonstration will attempt to identify the most effective strategies for
major, long-term changes in unhealthy habits, according to HHS.
“We are hopeful
that these approaches will help to sustain patients’ behavior change
over their lifetime, especially in the areas of physical activity,
nutrition, and smoking cessation,” said Berwick.
“We need to take
aggressive steps to help give everyone the tools they need to improve
their health.”
March 1, 2011 -
Senior citizens relying on the Medicaid program for medical care may
soon be offered a financial incentive to persuade them to adopt
healthier behavior, such as quitting smoking or losing weight. Last week
Health and Human Services said it is offering $100 million to states for
this purpose.