HJNO Jul/Aug 2026

Again, when we say helping Louisianians move from dependence to independence, it’s using our programs again as tools, as launchpads for Louisianians to achieve prosperity, and there are ways that we’re partnering up right now with the business community, with LouisianaWorks, and try- ing to make employment the product of our programs. I mentioned that we’re cutting out a lot of the middlemen in our healthcare system. This is a step-by-step process. We’re trying to have our money go to patient care rather than layers and layers of administration. Eighth, we have a very big effort in fight- ing fraud, waste, and abuse. And right now we’re in a very strong position. Again, I could go into the details on what the effect has been, but we’ve managed to save hun- dreds of millions of dollars in the last year by improving the fidelity of our eligibility in the program. We’re doing efforts right now to fight the rise in the cost of healthcare. We think about us as the Louisiana Department of Health for all Louisianians, not just the Department of Medicaid. So this [means] we think about employers and individuals as well. And then lastly, we talked about live lon- ger. We do want to extend the life of Lou- isianians by both the practice of healthy habits, healthy foods, and the proper con- sumption of healthcare services. So that’s what our Power 10 initiatives look like for 2026. Editor Thank you. Those sound good. I’d like to go back to a few of those, if I could. Greenstein Of course. Editor Louisiana’s life expectancy is roughly 73.8 years, compared to about 77.5 years nationally and nearly 80 years in the healthiest states. That suggests Louisiana could gain three to six years of life expectancy if it moved from the bottom toward the national average or the top tier. What is it going to take to give Louisianans those years back? Greenstein Yeah, I mean that goes to the very heart of the question: What are we doing and why? We think about every single one of our measures as dedicated to improving the outcomes for people’s health and we generally break it into two buckets and maybe you can help us on the marketing side of this, but we think about it as both live longer, which sounds right, but also die later, and we’re specific about these two pieces. So for example, for all the activity that we’re doing in opioid overdose reductions, that’s a die later function. We know everybody dies at some point, but too many people are too young when they’re saddled with substance use disorder and our goal is to make people get out of that situation and then live long, long lives, and that’s a die later example. The other one is when we think about cancer in our state, it’s vexing that we have pretty high rates, oftentimes in the top 10 or 15 performers in screening — breast can- cer screening, we were fourth in the nation two years ago; we’re 12th in the nation now. Colorectal cancer screening, we’re between 14th and 16th best in the nation, yet when we look at the death rates, we’re 44th and 46th in the nation, and that just doesn’t make sense to us. And so this is another exam- ple where while we have some of the best oncologists and departments of oncology in our health systems in the country — I’d compare ours to any other state around — we’re still not performing in terms of death rates and that’s because the process of get- ting care — either they’re getting screened too late in the game or they’re not getting connected to the care that they need. We’re losing patients’ lives in this process. And so that’s the die later category. For the others, whether it’s diabetes, congestive heart failure, or other chronic conditions, this is also what we’re focused on. This is the live longer portion, so we’re taking a bimodal approach to try to extend everyone’s lives, whether it’s the die later section or people that are already living into their 70s, and we’d like to see them extend it into their 80s, but this is a long process. We’re in it for the long run, and we’re excited about what we should see over the next 10 years. Editor What percentage of our cancer rates would you think are environmental? Greenstein That you’d have to refer to the researchers on. I don’t have comprehensive data in front of me. Editor Some of the data that they have doesn’t cover all of the cancers in all of the parishes. There’s a lot of blanks when I look at it. I get into studying those things; I find them interesting. You spoke about quality measures. Expand on that a little more. Are you guys pulling the quality measures? What are you measuring and/ or are you using national CMS numbers or how are you getting those quality measures and what are you measuring? Greenstein Yeah, so very good question. When we started out in this quality journey a couple of years ago, we began the process to look at how do we use our programs to enhance both the quality and the healthcare outcomes in our programs? So last year, we held the first annual Quality & Value Convention. We did it at the LSU Stadium actually. We had over 300 participants, and we announced several major changes to the Medicaid program. That is where we were traditionally; we had very soft measures in certain quality programs and we moved it to very specific HEDIS [Healthcare Effectiveness Data and Information Set] measure outcomes and health systems will be able to earn money based on their achievement of those goals or they miss getting certain payments, and we did the same thing with our health plans where we hold back 3% of total payment and then HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2026 11