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Healthy Indiana Plan HIP for Indiana

Healthy Indiana Plan HIP for Indiana. Journey to Excellence Indiana Rural Health Association August 20, 2009. Healthy Indiana Plan. What is it? What are its benefits? What are its challenges? What efforts are underway to make it successful?. HIP – What is it?.

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Healthy Indiana Plan HIP for Indiana

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  1. Healthy Indiana PlanHIP for Indiana Journey to Excellence Indiana Rural Health Association August 20, 2009

  2. Healthy Indiana Plan • What is it? • What are its benefits? • What are its challenges? • What efforts are underway to make it successful?

  3. HIP – What is it? • A state-funded health insurance program designed to address the uninsured problem • Funded through tobacco tax, fund shifts • Currently funded for 130,000 Hoosiers • 34,000 member cap on single adults • Structured as commercial insurance product • $300,000 annual coverage • $1 million lifetime coverage • POWER account • Consumer-driven healthcare

  4. HIP – What is it? • Plan eligibility • Indiana residents between 19-64 • Non-disabled caretakers, parents of SCHIP/HHW between 22-200% FPL • Childless adults under 200% FPL • Uninsured for at least 6 months • No access to insurance thru employer • Legal immigrants/resident 5 years

  5. HIP – What are its benefits? • Structured as commercial insurance • Administered through 2 Plans • Coverage includes unlimited preventive care • Full major medical coverage • Primary and specialty care (30/60 miles radii) • In- and outpatient hospital • Behavioral health & substance abuse • Pharmacy using generics formulary • Disease management through Enhance Service Plan • POWER account

  6. HIP – What are its benefits? • Coverage exclusions/non-covered: • Prenatal care • Vision care • Dental care • Chiropractic services • Non-emergency transportation • Out-of-Network services

  7. HIP – What are its challenges? • Program awareness • New program started in late 2007 • Placing value on healthcare • Services provided to indigents • Meeting target member group • Modernization difficulties • Funding beyond Childless Adult cap

  8. HIP – What are its challenges • Provider perceptions • Entitlement program • Administered like Medicaid • Identifying primary physician, network • Provider reimbursement • Reimbursement levels confusion • Program coverage area

  9. HIP – What efforts are underway to make it successful? • FSSA marketing efforts • Marketing through Plans • Enrollment through V-Can centers • Providers marketing/enrollment efforts • Owen County Initiative – Case Study

  10. HIP – What efforts are underway to make it successful? • Indiana Collaborative for Healthier Rural Communities • Robert Wood Johnson Foundation grant • Matching funds from public, private sectors • Tobacco Policy Change initiative • 5 rural Indiana communities • Public Health Policy initiative • 46 rural Indiana counties

  11. HIP – What efforts are underway to make it successful? • ICHRC -- 2 Public Health Policy Goals: • Increase the number of healthcare providers and panel size in rural counties accepting HIP patients. • Identify and reduce barriers for the purpose of increasing caretaker or parent enrollment in HIP in rural counties. • Rural providers role for Program success

  12. HIP – ICHRC Contact Info Jim Miller, ICHRC Project Director jmiller@indianarha.org (317) 769-4857 Dave Newgent, Owen Co. Family YMCA d_newgent@yahoo.com (812) 828-9622

  13. QUESTIONS?

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