CHARLESTON, S.C. - An ounce of prevention could save the state millions in Medicaid dollars, a governor's task force studying health care reform says.

The task force appointed by Gov. Mark Sanford said the state could save if Medicaid patients are encouraged to see a doctor regularly, rather than relying on more costly emergency rooms for their medical care when they become ill.

To do so, the state could reward physicians who keep their patients healthier, the task force suggested.

The group also endorsed an increase in the cigarette tax to help pay for Medicaid, the government insurance program for the poor.

Other suggestions included reforming the medical liability system, finding ways to provide health coverage for the working poor, and working to get people to take responsibility for their own health.

Sanford will review the recommendations, said his spokesman Will Folks.

Dr. Oscar Lovelace, the Chapin physician who chaired the task force, said encouraging preventive medicine through primary care can reduce costs.

The panel noted the Medically Fragile Children's Program in the Columbia area provides regular primary care to children in foster care and saved an estimated $1 million in one year. The $3.6 billion Medicaid program has 800,000 patients statewide.

"If the person has a medical home, they get good medical care, and it's less expensive to take care of them," said Dr. Charles Darby, a member of the task force and former chairman of pediatrics at the Medical University of South Carolina.

The task force also suggested changing the way the state pays doctors, reducing red tape and increasing Medicaid reimbursement to 100 percent of the average for Southeastern states.

Lovelace said the state could institute a reward system for doctors whose patients use emergency rooms less.

The task force said tobacco tax money should be used to help pay for Medicaid. Sanford said in his recent State of the State address he won't support an increase in the cigarette tax without a corresponding cut in the state income tax.

The task force report noted that settlements and judgments paid by the state's two main malpractice insurers increased 367 percent in the past five years. It recommended a $250,000 cap on non-economic losses and limits on attorneys' fees in malpractice cases. But it also said procedures should be developed to reduce medical errors.

The group also suggested the state develop an alternative health system for the working poor who can't get public or private health insurance.

Information from: The Post And Courier