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An Overview of Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) Grants

CALIFORNIA

Projected/Actual Implementation Date: March 2012

Initiative Title: Medi-Cal Incentives to Quit (MIQS) Project

First Year Grant Award: $1,541,583

Projected Number of Participants: 9,000

Description of Activities:

  • Smoking cessation counseling through a Helpline
  • Nicotine replacement therapy through the Helpline
  • Training health care providers on the Ask, Advise, and Refer intervention and increased awareness of the incentive program

Beneficiary Incentive

  • $20 gift card to pharmacies or grocery stores for calling the Helpline and participating in counseling sessions
  • Free nicotine-replacement therapy (NRT) patches by calling the Helpline
  • $10 gift card for every relapse-prevention call completed up to $40
  • After the first program year, $10-40 to re-enroll for participants who did not quit or relapsed

CONNECTICUT

Projected/Actual Implementation Date: March 2013

Initiative Title: Connecticut Rewards to Quit

First Year Grant Award: $703,578

Projected Number of Participants: 28,771

Description of Activities:

  • Counseling
  • Access to a Quitline
  • NRT and other medications
  • Specific medications (ix. bupropion)
  • Access to peer coaches
  • Pregnant women have a pre- and postpartum program focused on either continued smoking cessation or relapse prevention after birth.

Beneficiary Incentive

  • $5-15 for counseling visits, calls to the Quitline, and negative CO breathalyzer tests, with a maximum of $350 per 12-month enrollment period (max 2 enrollment periods/person)

HAWAII

Projected/Actual Implementation Date: February 2013

Initiative Title: Hawaii Patient Reward and Incentives for Supporting Empowerment Project (HI-PRAISE)

First Year Grant Award: $1,265,988

Projected Number of Participants: 2,500

Description of Activities:

  • FQHCs test individuals at high risk for diabetes
  • Diabetes education programs/self-management training
  • Care coordination
  • Health coaches

Beneficiary Incentive

  • FQHCs can determine the form of incentive
  • Tiered incentives for different activities (ex. attending diabetes management education or smoking cessation classes, achieving weight loss or improved blood test)
  • Participants can receive up to $215 annually for each year the participant maintains enrollmenta

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a FQHCs have flexibility to determine the form of the participant’s incentive (i.e. gift certificate, fee for gym membership, exercise classes, etc.).

MINNESOTA

Projected/Actual Implementation Date: November 2012

Initiative Title: Minnesota Medicaid Incentives for Prevention of Diabetes

First Year Grant Award: $1,015,076

Projected Number of Participants: 1,800

Description of Activities:

  • Diabetes Prevention Program (DPP) self-management training

Beneficiary Incentive

  • $25 debit card for attending first session
  • Supports to address barriers to participation, including meals during sessions, transportation, and child care
  • Participants assigned to receive either individual or individual plus group incentives
  • $10-$100 for attendance and weight loss goal attainment
  • $25 for follow-up clinic visit at the end of one year. • Maximum incentive amount per participant is $545

MONTANA

Projected/Actual Implementation Date: January 2012

Initiative Title: Medicaid Incentives to Prevent Chronic Disease

First Year Grant Award: $111,788

Projected Number of Participants: 726

Description of Activities:

  • Adapted Diabetes Prevention Program (DPP) self-management training

Beneficiary Incentive

  • Tiered and incrementally increasing financial incentives for self-monitoring, reduction of fat and caloric intake, and achieving more than 150 minutes of moderately vigorous physical activity per week
  • Maximum total cash incentive per participant is $315 annually

NEVADA

Projected/Actual Implementation Date: Feb-Sept 2013

Initiative Title: Medicaid Incentives for Prevention of Chronic Diseases

First Year Grant Award: $415,606

Projected Number of Participants: 9,816

Description of Activities:

  • Diabetes self-management education to adult beneficiaries
  • YMCA’s Diabetes Prevention Program for those at high risk of developing type 2 diabetes
  • Weight management program and support group for beneficiaries with a BMI >30
  • For children at risk of heart disease, the Children’s Heart Center Nevada’s Healthy Hearts Program (nutritional counseling; exercise program; counseling and motivational coaching)

Beneficiary Incentive

  • Points redeemable for rewards (through a web-based platform) on a tiered basis for participating in programs, efforts at behavior change, and achievement of improved health outcomes
  • Maximum incentives for various activities range from $38-$355

NEW HAMPSHIRE

Projected/Actual Implementation Date: May 2012

Initiative Title: Healthy Choices, Healthy Changes

First Year Grant Award: $1,669,800

Projected Number of Participants: 2,639

Description of Activities:

  • Weight Management program (24-month period followed by a 12-month period). Participants choose between a gym membership; In SHAPE, a motivational health promotion program for persons with mental illness; Weight Watchers; or a combination of In SHAPE and Weight Watchers.
  • Web-based decision support system to stimulate motivation to quit smoking. Then three options, which include combinations of prescriber referral for smoking cessation treatment, telephone-based cognitive behavioral smoking cessation therapy, and state Quit Line sessions

Beneficiary Incentive

  • For both the weight management and smoking cessation programs, half of the beneficiaries will receive the program as described, and half will receive additional rewards
  • Maximum incentive for the 24-month weight loss program: $3,097; 12-month weight loss program: $1,860; smoking cessation program: $415.
  • $10 for completing the web-based decision support system

NEW YORK

Projected/Actual Implementation Date: June 2013

Initiative Title: Medicaid Incentives for Prevention of Chronic Disease Program

First Year Grant Award: $2,000,000

Projected Number of Participants: 6,800

Description of Activities:

Four programs:

  • Smoking cessation
  • Blood pressure control
  • Diabetes management
  • Diabetes onset prevention

Beneficiary Incentive

  • Incentive group may be compensated for both process measures (ex. participating in counseling sessions, filling prescriptions) and outcome measures (ex. quitting smoking, losing weight, decreasing blood pressure) up to $250
  • Comparison group receives $50 for participating

TEXAS

Projected/Actual Implementation Date: April 2012

Initiative Title: Wellness Incentives and Navigation (WIN) Project

First Year Grant Award: $2,753,130

Projected Number of Participants: 1,250

Description of Activities:

  • Development of an individual wellness plan
  • Wellness planning with a trained health navigator to help achieve personal health goals
  • Flexible spending account to support specific health goals defined by the participant

Beneficiary Incentive

  • $1,150/year flexible spending account for up to three yearsb

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b TX indicated that money is not a primary form of incentive; however, participants receive monetary compensation for completing intake and yearly assessments. Participants are also able to request prevention- or treatment-related incentives associated with their health goals.

WISCONSIN

Projected/Actual Implementation Date: Sept 2012 – April 2013

Initiative Title: Striving to Quit (STQ)

First Year Grant Award: $2,298,906

Projected Number of Participants: 3,250

Description of Activities:

Two Programs:

  • First Breath program: Pregnant women receive prenatal face-to-face or telephone-based smoking cessation counseling, and postpartum smoking cessation counseling for up to 12 months
  • Tobacco Quit Line: Tobacco cessation services through a Quit Line

Beneficiary Incentive

  • Control group participants: incentives for taking biochemical tests
  • Treatment group participants: incentives for engagement in treatment and additional incentives for quitting smoking
  • First Breath intervention group receives a maximum of $600 over course of pregnancy plus 12 months postpartum; control group receives $160
  • Quit Line participants in the intervention group receive a maximum of $270 over six months; control group receives $80

 

SOURCE: Kathleen Sebelius, Initial Report to Congress: Medicaid Incentives for Prevention of Chronic Diseases Evaluation, U.S. Department of Health and Human Services, November 2013. http://innovation.cms.gov/Files/reports/MIPCD_RTC.pdf.

Status of MIPCD Programs to Date

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