ACP found that West Virginia's Mountain Health Choices Medicaid program—one of the first programs to use incentives—puts an emphasis on the patient's role in promoting good health. Mountain Health's evidence-based strategies increase access to prevention and treatment; support patient participation in decision-making; consider variables affecting comprehension and learning; and respect cultural, religious, and socioeconomic conditions. (It should be noted that The West Virginia University Institute for Health Policy Research in August 2009, offered a less generous assessment of Mountain Health.)
Regardless of the triumphs or shortcomings of Mountain Health, ACP's guidelines make sense for the larger wellness movement. There is no denying that we Americans are overweight and aging badly, and the costs associated with our graying, bloating population are staggering. We have to take responsibility for our own health. If we don't, who will? That's the appeal of wellness programs. We just have to make sure they appeal to everyone.