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Preliminary results from the new Health Enhancement Program (HEP) for state employees show decreasing use of specialists and increasing use of primary care. HEP is a wellness program that gives state employees incentives to manage chronic conditions and prevent new problems. HEP grew out of last year’s labor negotiations designed to both reduce costs and improve the quality of care – and it appears to be working. Emergency Room visits are down significantly and people with chronic conditions like heart disease, high blood pressure, high cholesterol and diabetes, are doing a better job taking their medications. The HEP results follow some very interesting FY12fiscal numbers in this presentation by the Comptroller’s Office. Once again, Medicaid dwarfs other line items in the budget at $4.7 billion. Even accounting for federal matching funds, it exceeds the next largest line item – salaries and wages. And rising Medicaid caseloads are a significant driver of the rising state budget. This is all the more reason to expand good ideas, like the HEP, to all state health spending and leverage the state’s success to improve the rest of the market.