Evaluation of Mountain Health Choices: Implementation, Challenges, and Recommendations

In 2006, West Virginia established Mountain Health Choices, a key component of the state’s Medicaid redesign efforts. The program offers low-income parents and children the choice of two benefit plans. Beneficiaries receive additional benefits when they follow basic rules that are designed to increase personal responsibility and strengthen their relationship to a medical home. This report shows that despite widespread support for the goals of the program, Mountain Health Choices has yet to realize its potential. Many people in the state believe the program may have difficulty achieving its goals because of implementation challenges. For example, beneficiaries and providers say they have not been receiving the continuous education and outreach they need to help beneficiaries make an informed choice of benefit plans. The authors recommend a series of improvements to enhance the program, including immediate and meaningful rewards for positive behavior changes.