Members of the Medicaid Reform Commission meet again on Thursday as they pour through the draft of a 70-page document being prepared for the Legislature. Medicaid Reform Commission Chairman Charlie Shields makes no apologies for the report’s emphasis on the need of prevention and individual responsibilty in health care. Several recommendations are made in nine categories, such as incentives to quit smoking and lose weight, increased reimbursement for doctors and hospitals who treat Medicaid patients, a reduction in paperwork, ending the abuse of emergency room visits, incentives to update technology to increase efficiency, and incentives to stay in the home rather than move to the nursing home. Shields says the recommendations should improve health care in Missouri, not necessarily cut Medicaid costs. Commission members return to the Capitol to consider changes to the draft report before a final document is written.