2nd Annual CHT Member Meeting "Creating a 21st Century Medicaid System"
| Date: September 27, 2006 | Location: Washington, DC |
Our second annual Medicaid conference, held on September 27th here in Washington, D.C., was a resounding success. For those who missed it in person, please note that the entire meeting, including the afternoon's two solutions workshops, is available via archived Webcast.
At a time when genuine bipartisan cooperation is all too rare, we sought to host a conference with the goal of bringing together diverse leaders in order to maximize the sharing of action-oriented solutions with the broadest possible audience. We were thrilled that over 150 public and private sector leaders (CHT members, guests and members of the media) gathered with us to explore recent changes to the Medicaid system and collaborate on ideas for the future of the program.
One of the day's highlights was the new polling information we received from Gallup, which showed strong evidence that consumerism's potential to improve heath and save money is not limited to only the private sector. According to the new poll, more than 65% of Medicaid beneficiaries reported that they would likely switch to a Medicaid plan that offered the incentive of a shared savings account [1]. The first of its kind in its examination of the role of incentives in changing Medicaid beneficiaries' behavior, this poll provides the groundwork for deeper exploration into the power of consumerism. While we know instinctively that better health is cheaper, accumulating more evidence to support our initiatives is critical to maintaining the momentum for innovative Medicaid transformation, and we are excited to pursue more research in this area.
The conference also featured presentations from some of the most dynamic and distinguished leaders in the Medicaid transformation movement, including Governor Ernie Fletcher (R-KY); Governor Bill Richardson (D-NM); Health and Human Services Secretary Mike Leavitt; Mrs. Glenna Fletcher, the First Lady of Kentucky; Virginia Secretary of Health and Human Resources Marilyn Tavenner; Jill Wiltfong of the Gallup Organization; and CHT founder Newt Gingrich. (To view all or one of these presentations, please see the archived Webcast of the event.)
The specifics of each presenter's speeches were distinct, but the common theme of the life- and money-saving potential of injecting personal responsibility into Medicaid -- whether it be through shared financial incentives, prevention/wellness efforts, and/or disease management reform -- ruled the day:
Kentucky Governor Ernie Fletcher advised the audience that providing the most vulnerable in our society with better health is of course "not only the moral goal," but it is also a financial imperative. Governor Fletcher utilized flexibility created by the Deficit Reduction Act to slow Medicaid cost inflation by $250 million in the past two years, said that his state was able to contain costs and improve care by "changing it to a model based on personal responsibility."
Mrs. Glenna Fletcher, First Lady of Kentucky, shared with us a program that she says has had a strong impact on encouraging prevention and wellness efforts. In order to encourage women to receive their recommended yearly mammograms, Mrs. Fletcher in 2004 began sending birthday cards to women between the ages of 65 and 69 (a group identified as being at risk for neglecting to continue their mammograms) that reminded them to "celebrate your birthday with a mammogram." The response of the outreach was so positive that Mrs. Fletcher has recently expanded it to groups of women on Medicaid, reminding them to get their yearly PAP screenings and mammograms.
Marilyn Tavenner, Virginia Secretary of Health and Human Resources, reported to the conference on the efforts of her state to streamline and improve the care they provide to Medicaid beneficiaries. Virginia has succeed in moving 60% of women, children, and non-disabled adults into managed care plans, and the state is now focusing on improving long-term care, disease management, better use of technology, and moving from a cost-based system toward a quality-driven payment model.
"Healthcare is the issue that bedevils the American people and governors more than anything," began Governor Bill Richardson of New Mexico, who reminded the ausience that the most important policy innovations in this country are coming from the state level. Governor Richardson called for the federal government to continue setting broad goals for the Medicaid program, and allowing states to generate the solutions. In New Mexico, with the help of CHT member ValueOptions, they are focusing on continuity of care and integrating the behavioral and mental health components of healthcare into the Medicaid program.
Secretary Leavitt outlined the Administration's recent efforts to encourage the proliferation of values-based health measures. Speaking on the importance of qualifying what the health system considers to be high-value care, Secretary Leavitt underscored the essential need to define clearly what we expect from our healthcare providers: "We live in a society where it is impolite to ask about the quality of healthcare, and no-one really has a need to ask about the price, because someone else pays for it," he said. What is necessary for a 21st Century Medicaid System, Secretary Leavitt continued, is to begin defining value in terms of cost and quality-- for all of healthcare, and not simply the Medicaid program.
While the American health system at large is working to become more consumer-oriented and quality-driven, advocates for Medicaid beneficiaries often argue that the stresses and burdens carried by this population cannot be alleviated through market-based reforms. However, as the Gallup poll indicates and as evidenced by the diverse experiences of the CHT conference speakers, innovation and choice lead to better quality and less waste in Medicaid. When it comes to Medicaid, better health is cheaper.
[1] Margin of Error: +/- 8%, survey fielded 13-18 Sep 2006. Respondents were asked, "It has been found that adopting healthy behaviors saves money for the healthcare system in the long run. Suppose your health insurance plan shared some of those savings with you by depositing money into a savings account each time you took an action to improve your health. If it were available, how likely would you be to switch to a Medicaid plan that offered a shared savings account?"
