New Hampshire Governor John Lynch in his State of State Address on January 21st, mentioned several initiatives his state is taking to lower healthcare costs and to provide better healthcare quality. The state is working online to provide better and more transparent information with cost data and information on outcome comparisons available between hospitals. Also, the state has made it possible for nearly all of the healthcare providers in the state to now prescribe medications electronically.
The Governor stressed that all patients should have a medical home where a primary care doctor coordinates the care so lower costs and improved healthcare will result. According to the Governor, nine medical home pilot projects across the state have been launched with doctors reimbursed for coordinating the care of their patients and the medical home pilot is proceeding with cooperation from major insurance companies with plans to expand the medical home model across the state.
The Citizens Health Initiative in New Hampshire is developing a pilot project to encourage hospitals in the state and provider groups to transform into “accountable care” organizations. The “accountable care” organizations would take what is learned through the medical home concept and expand the idea across health networks. Under this model, a healthcare system is given a budget for serving its entire community with the care then coordinated across its entire system, focusing on prevention and improving outcomes.
Governor Donald L. Carcieri of Rhode Island in his state budget address on February 4th highlighted a number of cost saving proposals that are specific to health and human service agencies in his state. He continued to say that the lion share of the savings involves the major components of the Medicaid waiver, smart purchasing, rebalancing the system, and providing savings through better care management and coordination.
He reported on five possible cost saving initiatives:
• Procure State’s Managed Care Contracts over again to highlight greater care coordination
• Provide for developmental disabilities reform to develop one or more networks of providers to foster a more responsive, accountable, and sustainable system of care for individuals with disabilities. Finance system improvements by increasing efficiency and by providing for more seamless and timely consumer access to services
• Provide for behavioral health reform and care coordination by developing a new coordinated payment system using a set of performance and financial incentives
• Redesign the Department of Children Youth and Families (DCYD) to better coordinate providers and care services. DCYF would be able to contract with one or more operational and fiscal partners that would be responsible for building a comprehensive network of formal and informal services to include residential and home-based services. This would further strengthen and support the home setting
• Provide for care management for long term care and rebalance long term care utilizing a contracted entity to manage primary, acute, and long term services for Medicaid only clients and also provide managed long term care benefits for clients with Medicare
