The Executive Director of the National Governors Association discusses programs that help motivate the consumer to be more directly involved in their healthcare.
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How do you add incentives to motivate the undermotivated to participate? Raymond Scheppach: Well, you're looking to big behavioural changes which are difficult. We have dealt with obesity and a number of other areas. Some of the areas you would adjust the copays, so if they are preventive services, the individual could surely does not have to pay any copay. So that's one way of doing an incentive. A lot of times, it's worth while doing some wrap around programs with a wellness group, where you have actually got mentors who get on the telephone with you every week and call you and say, you know did you're going for this test. How are you doing your exercise program and so on. So I think Wrap Around and also financial incentive -- programs to help people get off smoking are also possible. So I think clearly 40% of healthcare problems are due to lifestyle. In fact, that's about four times greater than what the global care gives us in terms of benefits. So it's an area we have got to spend a lot more money on. Which states have programs that look promising? Raymond Scheppach: Well of course, we have got three states that have done comprehensive either access or universal care, that being sort of Maine, Vermont and Massachusetts. So they have pretty complete systems in coverages in the 94%, 95%, 96%. So those are three leading states, but then you got states like Tennessee, they are doing good job in technology area, and Vienna in terms of integrating technology. Places like North Carolina are doing a pretty good job on setting the quality standards and enforcing those standards. So it's incremental across the states, but we have got about 35 or 40 states that are on paths now towards pretty much transforming the systems in their states.