Managed Healthcare Executive - February 2009 - (Page 13) month. State and matching funds would be deposited as a $476 lump sum in the rst month of enrollment. All told, the account would contain $1,100 to cover the annual deductible. POWER accounts are similar to the commercial market’s HSAs, but with one caveat: they only o er a rollover mechanism if individuals obtain state-speci ed preventive care. Ideally, the design will encourage members to obtain at least a minimum amount of preventive care, spend their money wisely, and become partners in managing their healthcare costs. It’s that aspect of personal responsibility that helped gain conservative support for the HIP concept. “The POWER account is designed to encourage people to seek a medical home, use a medical home and use preventive services,” McBeth says. “The extent to which they do that rewards them in future years with lower contributions. We’re hopeful that design in and of itself will have a positive impact on our healthcare utilization. From that standpoint, I think there’s a lot of value in looking at that in a national platform or in other states for Medicaid.” The list of state-required preventive services in order to rollover POWER funds is modest. For example, in 2008, members only needed to obtain a basic physical with a primary medical provider. In 2009, a few more requirements were added based on gender and age, such as women over age 40 must obtain a mammogram to gain their rollover bene t. Services are not subject to the deductible. MDwise also provides members explanations of bene ts and POWER account statements, which is unique for Medicaid and low-income populations, but it’s critical to drive appropriate utilization, she says. Surprisingly, MDwise discovered that HIP members have frequent access to the Internet, which is an ideal delivery channel for EOBs and account statements. Other aspects of personal responsibility also helped HIP gain biparti- san support. For example, if members has seen again and again that copays fail to make their monthly payments are not the solution for the low-income or fail to complete the annual redeter- population. She believes the POWER mination process, they lose coverage account strategy is working so far. and forfeit 25% of their saved POWER “We have had an outstanding reaccount contributions. Terminated sponse in terms of people paying their members cannot re-enroll for at least bills and paying them on time,” she 12 months. says. “If after 60 days [members] haven’t made their payments, they’re out of the program, and they’re out for 12 months. That shows that when you align the incentives and you create the appropriMDwise ate policies, you’re going to have better 1099 N. Meridian St. behavior. That’s what we’re seeing. We Suite 320 have a very low termination rate for Indianapolis, IN 46204 nonpayment.” FOUNDED: 1994 In fact, data from the state shows that in November 2008, fewer than 200 EMPLOYEES: 150 HIP members (0.5%) were terminated MODEL: Non-pro t; integrated for nonpayment of their monthly condelivery system tribution. Verma says models that use TOTAL MEMBERS: 300,000 taxpayer dollars to fund health coverage PRODUCTS: should demonstrate members’ nancial • Healthy Indiana Plan (subsidized, responsibility. low-income adults) “People hate the idea of handing • Hoosier Healthwise (pregnant women members a Cadillac with no strings and children in Medicaid) attached,” she says. “In terms of being • Care Select (aged, blind, disabled in a national model, you can’t develop a Medicaid) product for low-income people that doesn’t have any personal responsibilWhile HIP o ers a consumerized ity mechanisms in it if you hope to atbene t design, there might not be much tract conservatives.” interest at the national level for HSA plans that are o ered through the indi- Long-Term Plan vidual and small group insurance mar- Many credit Governor Mitch Daniels kets, according to Claire Miley with for not only driving the Healthy Indithe healthcare industry practice of Bass, ana Plan to execution but also for bringBerry & Sims PLC in Nashville. ing new jobs to the state in recent years. “The new administration may instead Today’s economic crisis now puts added look into alternatives such as creating a burden on state budgets at a time when national health insurance exchange or more public funding is needed. creating large pools of employer-based Indiana’s uninsured population fell coverage so that people will not have to from 13.7% in 2005 to 11.6% in 2007. seek health insurance in the individual Undoubtedly rising unemployment and small group markets,” Miley says. (now at 7%) will cause the gure to rise again. Interestingly, Indiana claims Precise Alignment one of the highest rates of employerSeema Verma, consultant for the Indi- sponsored coverage, but that, too, is on ana Family and Social Services Admin- a declining slope, slipping from 75.7% istration, and one of the architects of the of the insured population in 2001 to Healthy Indiana Plan, says she’s worked 70.5% in 2007. on healthcare reform for 10 years and Against this backdrop of tight budFEBRUARY 2009 13
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.