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The federal government would take more responsibility for long-term care, while individual states would focus more on the disabled, children and pregnant women under a “Medicaid Makeover” plan issued Friday by former Health and Human Services Secretary Tommy Thompson.

“We must realign responsibility for Medicaid so that the federal government assumes a larger role in planning, delivering and paying for services for the elderly while allowing the states to take on greater responsibility for caring for those under 65,” Thompson said.

Focusing on prevention and innovation will help ease problems caused by rising costs and growing beneficiary enrollment, according to the plan, which can be found at www.medicaidmakeover.org.

In addition, pay schedules under Medicaid “should be updated to reward quality of care, rather than simply quantity of services, and states should be encouraged to undertake eHealth initiatives to improve quality, safety, and cost-effectiveness across the Medicaid care continuum,” Thompson said.

Thompson says he plans to present his four-point plan to “key opinion leaders” and report “periodically” on progress and what more can be done to improve Medicaid.