Medicaid Reform: Beneficiaries Earn Enhanced Benefits Credits But Spend Only a Small Proportion

Source: Florida Legislature, Office of Program Policy Analysis and Government Accountability, Report No. 08-45, July 2008

The Medicaid Reform enhanced benefits account program rewards beneficiaries for participating in activities that can improve their health. Beneficiaries can earn credits up to $125 per year which are maintained in individual enhanced benefits accounts. Beneficiaries can earn these credits in a variety of ways including keeping doctor appointments, taking preventive measures such as mammograms and immunizations, and participating in disease management or other activities to improve their health such as smoking cessation and weight-loss programs. Beneficiaries can redeem their credits at participating Medicaid pharmacies to purchase health-related products. From September 2006 through April 2008, beneficiaries had earned credits totaling nearly $13.8 million and had redeemed about $1.6 million (11.4%) of this amount for health-related products.

Stakeholders are concerned that some Reform beneficiaries are unaware of the program or may find it difficult to redeem earned credits. In addition, the program design may not adequately support long-term change in healthy behaviors. While the Agency for Health Care Administration has taken steps to improve beneficiaries’ awareness, additional operational and program design challenges remain.

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