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SETTING COST SHARING GUIDELINES LESSONS LEARNED

SETTING COST SHARING GUIDELINES LESSONS LEARNED. Since Its First Enrollment Healthy Kids Has Experienced Increases and Decreases in Premiums Paid by Families During This Time, Copayments and Benefits Remained Consistent

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SETTING COST SHARING GUIDELINES LESSONS LEARNED

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  1. SETTING COST SHARING GUIDELINESLESSONS LEARNED • Since Its First Enrollment Healthy Kids Has Experienced Increases and Decreases in Premiums Paid by Families • During This Time, Copayments and Benefits Remained Consistent • The Effect Each Change in Cost Sharing Has Had on Enrollment Has Been Evaluated by the Corporation

  2. ELIGIBILITY

  3. ENROLLMENT HISTORY

  4. COST SHARING Family Contributions To Monthly Premiums

  5. CURRENT ENROLLMENT BY SUBSIDY LEVEL Coverage: August 1998

  6. ENROLLMENT BY SUBSIDY LEVEL A Comparison of Enrollment when Full Subsidies are Available After one year of enrollment

  7. ENROLLMENT AS PERCENTAGE OF POPULATION Percent of School-Age Children who Enrolled in Healthy Kids After one year of enrollment

  8. HEALTH CARE UTILIZATION • Families Who Contributed the Monthly Premium Were Twice As Likely to Access Health Care Services As Those Who Were Not Required to Pay a Monthly Premium • It Was Determined From This That Families Who Contribute at Least Some Portion of the Monthly Premium Are More Likely to Access Health Care

  9. ENROLLMENT BY SUBSIDIZED COVERAGE After Increase in Monthly Premium 10,000 August September

  10. ENROLLMENT IN VOLUSIA COUNTY After Increase in Premium

  11. EFFECT OF PREMIUM INCREASE ON ENROLLMENT VOLUSIA COUNTY:FULLY-SUBSIDIZED PREMIUMS WERE INCREASED TO $15 PMPM • Families in the Fully-Subsidized Category Were More Likely to Disenroll • These Families Were More Likely to Re-Enroll Their Children After 2 or 3 Months of Dropping Coverage

  12. DISENROLLMENT • When a Monthly Premiums Were Increased for All Families, 39% of Participants Disenrolled From the Program: • 80% were previously fully-subsidized • 20% received a partial or no subsidy AS A RESULT OF INCREASE IN FAMILY PREMIUM PAYMENTS

  13. HEALTH SERVICES ACCESSED • 80% of Families Who Contributed to the Monthly Premium Accessed at Least One Health Care Service Within 12 Months of Enrollment • 55% of Families Who Were Not Required to Pay a Monthly Premium Accessed at Least One Health Care Service Within 12 Months of Enrollment

  14. ENROLLMENTWITH IMPLEMENTATION OF TITLE XXI

  15. EFFECTS OF REDUCTIONS IN COST-SHARING • The Change in Enrollment After the Premium Decreases Is Minimal • Additional Time and Data Will Be Needed to Assess the Full Impact These Changes Will Have on Enrollment AFTER AN INITIAL LOOK

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