Indiana Health Coverage Programs

Member Access

October 15, 2015

Where We Are Today

June 2014 August 2015

Provider Classification

Billing, Group, Dual

Rendering Providers

15,182 38,391

Provider Classification

Billing, Group, Dual

Rendering Providers

15,049 35,466

Total Providers

50,495 Total Providers 53,573

Program Enrollment

Traditional Medicaid 283,036

HHW 606,740

HIP 309,311

Hoosier Care Connect 96,893

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15Other IHCP 320,909 330,895 331,690 335,516 355,073 358,299 358,882 362,115 361,275 349,542 355,558 355,615 345,580 326,654 328,122 317,193 271,434 283,036

HHW 690,298 675,276 683,081 688,938 672,272 669,216 672,130 675,651 670,236 668,289 667,811 597,750 600,264 604,217 601,772 602,190 606,890 606,740

CareSel 36,274 33,990 32,872 36,650 35,900 34,800 34,438 32,679 32,013 43,063 40,887 39,989 38,785 35,320 32,964 29,313 7,583 -

HIP 41,928 46,723 43,485 47,613 51,987 56,041 59,947 60,973 60,913 60,281 59,259 141,169 181,186 235,075 263,711 279,095 294,396 309,311

HCC 7,535 13,193 29,928 96,007 96,893

IHCP Enrollment Distribution March 2014 through August 2015

Hoosiers Living in Poverty

0

50

100

150

200

250

300

350

ALLEN , ALLEN

ELKHART

LAKE

MARION

OUT OF STATE

ST. JOSEPH

VANDERBURGH

Number of Transportation Providers per County

Counties

Num

ber

of

Pro

vid

ers

Family Member Providers

0

10

20

30

40

50

60

70

ALLEN

DELAWARE

ELKHART FAYETTE

HARRISON LAKE

MARION

MORGAN ORANGE PORTER

RIPLEY ST. JOSEPH

VANDERBURGH

WASHINGTON WAYNE

WHITE

40

15

10

5

0

Ambulance

CAS NAS

150

15

10

5

0

60

15

10

5

0

Family Member

3%

20%

18%

18%

17%

24%

Air Ambulance Ambulance CAS Family NAS Taxi

Transportation Providers, by Type

Primary Care Panels Programs June 2014 January

2015June 2015

Hoosier Healthwise

5,270 5,727 5,767

HIP 4,278 4,896 6,078

Hoosier Care Connect

N/A 8 5,294

Total 9,548 10,631 17,139

Behavioral Health Providers

Provider Type Total Number Enrolled

Outpatient Mental Health Clinic 877

Community Mental Health Center (CMHC) 231

Health Service Provider in Psychology (HSPP) 1,547

Psychiatrist 1,578

Community Mental Health Centers

Outpatient Mental Health

Clinics

HSPP’s

Psychiatrists

250

15

10

5

0

Adams

Allen

Bartholomew

Benton

Black-ford

Boone

Brown

Carroll

Cass

Clark

Clay

Clinton

Crawford

Daviess

Dearborn

Decatur

Dekalb

Delaware

Dubois

Elkhart

Fayette

Floyd

Fountain

Franklin

Fulton

Gibson

Grant

Greene

Hamilton

Hancock

Harrison

Hendricks

Henry

Howard

Hunting -ton

Jackson

Jasper

Jay

Jefferson

Jennings

Johnson

Knox

Kosciusko

LaGrange

Lake

LaPorte

Lawrence

Madison

Marion

Marshall

Martin

Miami

Monroe

Montgomery

Morgan

Newton

Noble

Ohio

Orange

Owen

Parke

Perry

Pike

Porter

Posey

Pulaski

Putnam

Randolph

Ripley

Rush

St. Joseph

Scott

Shelby

Spencer

Starke

Steuben

Sullivan

Switzerland

Tippecanoe

Tipton

Union

Vanderburgh

Vermillion

Vigo

Wabash

Warren

Warrick

Washington

Wayne

WellsWhite

Whitley

Does not meet HRSA standards, no one to recruit

Does not meet HRSA Standards, need to recruit

Meets HRSA Ratio, Potential at risk

Meets HRSA Standards - Ratio 10000:1

IndianaAIM Member information 7/2015; All Mbrs-Medicaid, Pkg-C, & 590 pgms. Provider Information obtained from National Plan Provider Enumeration Systems (NPPES) July 2015, Health Resources and Services Administration (HRSA) 03/31/09, and IndianaAIM July 2015

A look into the future

• CMHC primary care services – January 2016 implementation target– Provide coordinated, holistic care to those

you already serve– Enrollment

• Have appropriate providers to render these services

• Enroll them as rendering providers with Indiana Medicaid

Where we are going

• Governor’s substance abuse taskforce– Who are our providers?– Examine Indiana Medicaid coverage

• Opioid treatment• Other substance abuse treatment options

– Outpatient– Inpatient– Best practices and models of care

Technology improvements

• Bringing up new MMIS system– More provider friendly to relieve

administrative burden• Online enrollment/revalidation/updates• Online PA submission with attachments• Member management features• Secure correspondence• Electronic claim attachments• Enhanced RA access

Contracting

• State procuring managed care contracts– Hoosier Healthwise– HIP

• Enhanced requirements for access• Focus on quality and outcomes• RFP available online now• Review beginning January 2016 with selection

summer 2016• Implementation January 1, 2017

Access Initiatives Moving Forward

• Examine the role of advanced practice and mid-level providers• APNs rounding in Inpatient Psych setting• Enrolling all APNs and PAs to increase provider pool

• Bring Indiana current with industry standard• Review of mental health mid-levels to explore the possibility of

expanding their roles • Examination of oversight and current billing rules and policies• Regulatory review

Initiatives Cont.

• Increased involvement with provider associations and organizations• Increase Indiana state employee presence at meetings• Seek feedback on publications, policies, and program updates

• Explore partnerships with Colleges/Universities• Keep Indiana-trained resources in state• Educate future professionals on Indiana Health Coverage

Programs

Initiatives Cont.

• DMHA health home project (ICE)

• Continued education throughout Indiana• Increase community involvement• More visits to smaller communities• Using hospitals as central point of contact

Contact Information

• Questions?

• Contact InformationScott Gartenman, FSSA Provider Relations Director

Scott.Gartenman@fssa.IN.gov