Faced with hundreds of millions of dollars in tax increases from the state, New York health plans are hunkering down for a lean 2009. Four of the 10 major carriers in the state posted net losses in 2008 with Health Insurance Plan of Greater New York losing the most, $84 million. Health plans face more than $700 million in new taxes to help plug budget holes in New York; in Connecticut, the governor is considering cuts to Medicaid while in New Jersey, legislators are considering limiting enrollment in NJ FamilyCare, the state-subsidized insurance program for low-income adults and families. CIGNA HealthCare has launched one of the first moves in outcomes-based pharmacy contracting with Merck & Co., built around Merck's drugs, Januvia and Janumet, used to treat Type 2 diabetes. In the Rochester market, Excellus Blue Cross Blue Shield and MVP Health Care are funding a medical home program for adult primary-care practitioners. In New Jersey, UnitedHealthcare could potentially gain 10,000 members by offering 5 percent discounts to social services agencies.