Should Scarce Medicaid Resources Be Spent on Incentive Programs?
Medicaid has far-reaching responsibilities. It finances not only health coverage for low-income adults and children, but also medical and long-term care for people with disabilities and, for the elderly, long-term care and help with Medicare premiums and cost sharing. State policymakers must frequently make difficult choices about how best to use finite Medicaid resources to assist these vulnerable populations. Rewarding beneficiaries for behavior is unlikely to have significant effects either in reducing Medicaid program costs or in improving the overall health status of the Medicaid population. Rewards may have some use in increasing receipt of preventive care, particularly if they are combined with other strategies such as outreach and education. However, these strategies have not been proven cost-effective in Medicaid when employed without education or outreach. Moreover, as Florida’s experience shows, states will incur costs to launch, promote, and oversee these programs, in addit
