Howard County in Maryland is proposing a pilot demonstration project for uninsured patients.
Rather than planning a grandiose project that would fall short of their goals, they have set a limited program on a fairly small scale, working from the ground up.Central to the program is careful case management and 'health coaches'. Enrollment in the program and continuing benefits is predicated on the requirement that patients enroll and continue in the coaching program.
The program called "Health Howard" offers a window for other counties and states can reform their medicaid programs. It appears to be well thought out and organized. Cost containment is built into the program from the beginning with personal coaching and commitment to each patient. The outcomes will be better measured by individual sucess of each patient rather than financial measures.