The waiver will allow the state to move its Medicaid program to an Affordable Care Organization (ACO) model, which provides financial incentives to promote successful patient outcomes and moves away from the current fee-for-service structure.
"One of our greatest budget challenges is the unrestrained growth of our Medicaid program," said Governor Herbert. "Our plan is patient-focused and provides for healthier people; it promotes individual responsibility and consumer choice; and it saves money by providing financial incentives to keep people healthy, not just perform tests and procedures on them."
"I appreciate the leadership demonstrated by Governor Herbert, President Waddoups, and Speaker Lockhart as we try to make these important changes to the state's Medicaid program," said Dr. David Patton, Executive Director of the Utah Department of Health. "The Medicaid waiver we have requested from the Center for Medicare and Medicaid Services (CMS) will allow the state to better align payments to support quality care and avoid unnecessary care."
"We need flexibility from the federal government in order to find solutions which respond to Utah's unique demographics and dynamics," Governor Herbert said. "While this reform represents a fundamental change in our state's Medicaid system, it's essential to realize that the status quo is unsustainable and threatens the very purpose of the Medicaid program, which is to provide a safety net for our most needy citizens. Not only will our reforms stabilize our Medicaid program, they will strengthen it and provide better health outcomes for Utahns."