Amid a backdrop of repeal-and-replace turmoil and intraparty bickering, Verma enters the national stage at a moment that might be seminal for the future of federal health programs in our country.
Which begs the question: Is Indiana the future of Medicaid? Is the Hoosier State, which re-engineered its Medicaid program under the stewardship of Verma and the blessing of Vice President and then-Gov. Mike Pence, the blueprint for the nation?
Alas, Part B News lacks a crystal ball. But where we fall short in prognosticating we make up for in analyzing. To that end, we have assessed the Medicaid program in Indiana, known as the Healthy Indiana Plan (HIP), to find out how it operates. Please extrapolate these findings with caution.
- It's consumer-directed. That sounds great, but what does it mean? The HIP program pairs two key elements -- a high deductible and the use of a health savings account (HSA) -- to cover medical expenses. As Part B News reported recently, the expanded use of HSAs may translate to big changes in your collections strategy -- instead of wrangling with insurers for payment, you'll likely deal directly with the patient.
- It has deductibles and copays. The deductible for a HIP plan is $2,500, and the state Medicaid program pays for a large portion it. For example, a member with a monthly income of roughly $1,400 pays about $28 per month into the health savings account. A member who earns about $450 per month pays only $9 into the program. The HIP plan covers the remaining costs, excluding copays, until the patient reaches the deductible ceiling.
- It's philosophical. Well, it hinges on ideological policymaking, anyway. The high-deductible plan "protects [members] from catastrophic medical expenses, while the deductible exposes members to the costs of their care and engages them to manage their use of services appropriately," states the HIP website. What's more, consumer-directed health plans foster "competition in the marketplace as patients become active consumers and providers compete to provide services, lowering prices and increasing quality."