Indiana Family and Social Services AdministrationOffice of Medicaid Policy and Planning

Indiana Health Coverage ProgramsMoving Forward

October 17-19, 2017

State Initiatives

Medicaid Enrollment

Healthy Indiana Plan

Coming Soon

Agenda

State Initiatives

Governor Holcomb’s Five Pillars

I. Cultivate a strong and diverse economy by growing Indiana as a magnet for jobs

II. Create a 20-year plan to fund roads and bridges

III. Develop a 21st century skilled and ready workforce

IV. Attack the drug epidemic

V. Deliver great government service

I ii iii Iv v

Medicaid Enrollment

Medicaid Members

1.4 million members; $11 Billion expenditures– 650,000 children

– 400,000 adults

– 40,000 pregnant women

– 100,000 seniors

– 210,000 people with disabilities

– 110,000 dual eligibles

– 26,000 ex-offenders

Note: Members can be in multiple categories

Managed Care1.1 million members

Medicaid/CHIP Kids

Pregnant Women

Parent/Caretakers

Expansion Adults

Aged, Blind and Disabled in community

Foster Kids (voluntary)

Fee for Service

300,000 members

Dual Eligibles and Medicare Savings Program

Nursing Home Residents

Limited Benefit Categories

HCBS Waiver Recipients

Foster Kids

Enrollment by Delivery System

Managed Care Assignment

PlanHoosier

HealthwiseHoosier Care

ConnectHealthy

Indiana PlanPlan Total

Anthem 205,300 57,107 179,988 442,395

CareSource1 44,439 01 32,841 77,280

MDwise2 228,321 02 123,530 351,851

Managed Health Svcs.

155,314 34,039 79,376 268,729

Program Total 633,374 91,146 415,7353 1,140,255

1 CareSource’s contract with Indiana first became effective on January 1 of this year, and does not include the Hoosier Care Connect program.

2 MDwise stopped offering Hoosier Care Connect in their product line as of April 1 of this year. These members have been reassigned to Anthem or MHS.

3 Enrollment as of September 2017

Healthy Indiana PlanUpdate

HIP Goals

• Goal 1: Reduce the Number of Low-income, Uninsured Indiana Residents and Increase Access to Healthcare Services

• Goal 2: Promote Value-based Decision Making and Personal Health Responsibility

• Goal 3: Promote Disease Prevention and Health Promotion to Achieve Better Health Outcomes Goal

• Goal 4: Promote Private Market Coverage and Family Coverage Options to Reduce Network and Provider Fragmentation within Families Goal

• Goal 5: Provide HIP Members with Opportunities to Seek Job Training and Stable Employment to Reduce Dependence on Public Assistance

HIP Enhancement

Substance Use Disorder (SUD) Treatment

• Fill treatment gaps by adding new services: inpatient detox, residential treatment, and addiction recovery services (recovery education, peer recovery support services, housing support services, recovery focused case management and relapse prevention)

• Lift current Medicaid restriction on IMD providers –expand access of at least 15 more facilities with 12 additional in que

• Within HIP, MCEs will use member incentive programs to influence behaviors – including targeting SUD treatment

Coming Soon…

Updates

• Centralized Credentials Verification Organization (CVO)– Create one-stop shop for provider enrollment and

credentialing

– RFP completed; Conduent selected

– Partnering with MCEs and provider groups

• Electronic Visit Verification

• Non-emergency medical transportation broker– Broker selected; contract in progress

Thank You!