Healthy Indiana Plan HIP for Indiana

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?