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Proposal to Coordinate Medicare and Medicaid is 2012 Competition Winner

BOSTON, MA – Pioneer Institute is pleased to announce the winner of the 21st annual Better Government Competition (BGC): “Coordinating Medicare and Medicaid to Improve Care,” a proposal to integrate acute and long-term care benefits for those eligible for both programs into a single, comprehensive system managed by the states. The winning entry was submitted by Grace-Marie
Turner of the Galen Institute, and Robert Helms, Ph.D., of the American Enterprise Institute.

The winner and four runners-up were selected by a distinguished panel of judges from the business, academic, and media communities:
Charles D. Baker, Jr., Executive in Residence, General Catalyst Partners
Stephen D. Fantone, Ph.D., President and CEO, Optikos Corporation
Ken Johnson, Editorial Page Editor at The Eagle-Tribune
John F. Moffitt, President, Andover Strategies, Inc.
Richard L. Schmalensee, Howard W. Johnson Professor of Economics and Management at the Massachusetts Institute of Technology

Nationally, there are about 7.5 million dual-eligible beneficiaries, which carry a total cost of $158 billion.

Massachusetts is home to 250,000 dual eligibles; and combined Medicare and Medicaid spending totals approximately $750 million. Demonstrations and experience gained through pilot programs have shown that increased use of coordinated care will lead to a 40 to 50 percent drop in hospitalization and savings to the Medicare and Medicaid programs on the order of 10 percent.

If implemented, Medicaid Advantage would ensure that Medicaid’s neediest recipients receive the right care in the right setting. These patients account for 40 percent of Medicaid spending, and a much higher share of total spending than non-duals. The new program would save billions of dollars by streamlining cumbersome rules and eliminating spending inefficiencies.

“This is a highly practical idea, and one where Massachusetts has gingerly dipped its toe in the water,” says Jim Stergios, Executive Director of Pioneer Institute. “The fact is that if it were implemented successfully here in the Bay State, this proposal would put MassHealth, the state’s Medicaid program, on a stronger financial footing. When every year, we watch state lawmakers scramble to close the
program’s billion-dollar spending gap, helping solve the Medicaid riddle is critical.”

The 2012 Better Government Competition runners-up are:

Devolving Responses to Natural Disasters: By paying 75% of state-federal disaster relief, the federal government has created incentives to expand the number and cost of disasters, even as the quality of the responses has decreased. Author: Matt A. Mayer, Visiting Fellow, The Heritage Foundation

Reducing Congestion through Focusing on Performance: Basing operational decisions on quantitative measures of performance and accountability will focus state Departments of Transportation on attaining key goals for users of highways, transit and other modes of transportation. Authors: Wendell Cox, Alan E. Pisarski, and Ronald D. Utt, Ph.D.

Devolving U.S.A.I.D. Training to State Colleges and Universities: Devolving “participant training” functions to state departments of higher education and state colleges and universities will match participants with higher quality training at significant savings. Author: Matthew Auer, Professor, School of Public and Environmental Affairs, Indiana University

Increasing Transparency in Government Use of Financial Derivatives: To maintain the public trust, state and local governments should be required to disclose information concerning transactions in their (taxpayer-supported) pension funds, so that they are at least as regulated as derivatives transactions in the private sector. Author: Greg Kaza, Executive Director, Arkansas Policy Foundation

To learn more about this year’s winning entry, runners-up, and special recognition recipients, please visit Pioneer’s website:

“With states and the federal government having to face up to enormous long-term liabilities and budget challenges, this competition promotes responsible solutions that build on the best aspects of our federalist system to deliver high-quality services and benefit the bottom line,” said Stergios.

Pioneer Institute’s Better Government Competition, founded in 1991, is an annual citizens’ idea contest that rewards the most innovative public policy proposals in the country. The 2012 competition focused on devolving federal programs back to the states, to bring about cost savings, more effective delivery of services, and innovation. The Competition grand prize winner will receive $10,000; four
runners-up receive $1,000 each, and other proposals receive special recognition.

“The hundreds of entries received this year demonstrate a live interest in exploiting the strengths of the nation’s federalist system. We are thrilled by the quality of the entries, and Pioneer is grateful to the many individuals and organizations that took the time to submit,” says Shawni Littlehale, director of the Better Government Competition. “The submissions provide real opportunities to improve
government on a wide variety of services, from higher education, disaster relief, and road congestion, to regulatory reform and health care.”

The 21st annual Better Government Competition Awards Ceremony is scheduled to take place in September 2012. At the event, Pioneer Institute will recognize award winners before an audience of elected officials, policy leaders, and members of the business community.