In Georgia and Louisiana, state government is the largest employer and insures the largest group of people. In both states, cost saving changes are under way. Louisiana is looking at privatizing its state employee PPO and will add a consumer-driven health plan option in the upcoming fiscal year. Georgia is pushing for CDHPs and has already seen success in this enrollment and in its wellness initiative. Alabama, Georgia and Louisiana have all seen Medicaid increases due to the recession and, in the case of Louisiana, a strong push to add members to its Children's Health Insurance Program, LaCHIP. In Alabama and Louisiana the increase in Medicaid was accompanied by a decrease in commercial enrollment, but in Georgia that trend didn't happen. Enrollment in commercial plans in Georgia went up by 4 percent in the first half of 2009, the latest period for which data is available. Brokers in all three states warn that when the rest of 2009 enrollment is tallied, there will probably be enrollment losses. In Georgia and Alabama insurers Humana and Blue Cross Blue Shield are both pursing medical home pilots, and Humana has data to prove both improved medical outcomes and reduced costs. The Alabama Blue plan launched a patient-centered medical home last fall that features incentives for physicians. The city of New Orleans has adopted UnitedHealthcare's new diabetes program for city employees in the expectation of improving health outcomes and saving nearly $1 million annually.