State Health Plan Aims to Cut Costs, Improve Lifestyles

By JOSIE HUANG Staff Writer

A proposed state health plan takes the unusual step of asking Mainers to sign confidential contracts to improve their health.

Under a premise developed by Gov. John Baldacci’s office, a person would set specific goals such as losing 10 pounds or walking a mile a day, then voluntarily sign a contract with a doctor or a family member.

Research shows that a written commitment to another party results in better outcomes than personal vows such as New Year’s resolutions, said Trish Riley, Baldacci’s health policy director.

"Each of us have something we could do to reduce our risk of illness, but not everybody does it," said Riley, director of the governor’s Office of Health Policy and Finance. "This is a way to keep people focused."

The idea puts a new spin on the state health plan, a two-year road map to be used by state officials, lawmakers and the health- care community in developing programs and policies.

The plan will be finalized by mid-to-late December, after a state advisory council takes public comment on the draft and it gets reviewed by the Legislature’s Health and Human Services Committee.

Maine residents spend more of their income on health care than residents in 45 other states, Riley said.

Three-quarters of health-care spending goes toward the treatment of chronic illness such as cancer, heart disease, lung disease, diabetes and depression, she said.

Abandoned two decades ago, the state health plan was revived in a one-year format under Baldacci’s Dirigo Health reform program to maximize efficiency and improve quality in the health-care system.

The draft plan continues support for Dirigo Health initiatives such as limits on expansion by hospitals and other care providers to curb spending.

It also supports the expansion of the state-sponsored DirigoChoice health-insurance program by at least 100 percent.

More than 8,300 people are in the program.

A new emphasis on strengthening Maine’s public health system by better connecting state and local groups and by reducing chronic illnesses won raves from the Maine Hospital Association, a frequent critic of the administration’s health-care policies.

Mary Mayhew, a lobbyist for the trade group, said the draft plan does a much better job than the last one in "addressing chronic disease both in terms of prevention and proper treatment."

Highlights of the 83-page plan include:

During the state approval process, give high priority to projects from hospitals and other providers if they include pledges to spend 1 percent of the project’s cost to support public health.

Prevent chronic illnesses by promoting a "care model" in which clinicians work collaboratively with one another and regularly see patients.

Create a screening tool to identify depression and conduct a pilot project to increase screening and treatment.

Have The Maine Quality Forum, the state’s health-care watchdog group, focus on improving the speed and effectiveness of treating heart attacks.

"This is critical because it’s a leading cause of death and time is incredibly important to each individual patient," said Dr. Dennis Shubert, the group’s executive director.

The governor-appointed Advisory Council on Health Systems Development, representing hospitals, doctors, insurers, consumers and business, will hold public hearings on Nov. 21 and 22 in Lewiston, Brewer and Portland.

Staff Writer Josie Huang can be contacted at 791-6364 or at:

jhuang@pressherald.com