ArnoldView Graph # 1 OVERVIEW Role of Cost-Sharing Experience With Cost-Sharing in Child Health Plus - Premiums - Copayments Assessing Our Cost-Sharing.

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Presentation transcript:

ArnoldView Graph # 1 OVERVIEW Role of Cost-Sharing Experience With Cost-Sharing in Child Health Plus - Premiums - Copayments Assessing Our Cost-Sharing Choices

ArnoldView Graph # 2 Deter Unnecessary Utilization Encourage Personal Responsibility Defray the Cost of the Subsidy Reduce Substitution of Private Coverage ROLE OF COST-SHARING

ArnoldView Graph # 3 State Subsidized Health Insurance Program for Children Between 100% and 222% of Poverty Benefits Include Primary and Acute Care Families Are Responsible for Small Premium Contributions and Copayments Health Insurance Is Provided Through Managed Care Plans OVERVIEW OF CHILD HEALTH PLUS

ArnoldView Graph # 4 Premium Contributions Copayments EXPERIENCE WITH COST-SHARING IN CHILD HEALTH PLUS

ArnoldView Graph # 5 Promote Personal Responsibility Encourage Purchase of Coverage Deter Substitution of Private Coverage Align With Other States Cost-Sharing Requirements DRIVING FACTORS IN SETTING PREMIUM CONTRIBUTIONS

ArnoldView Graph # 6 PREMIUM COST-SHARING IN CHILD HEALTH PLUS

ArnoldView Graph # 7 Insurers Determine Eligibility and Enroll Families in Child Health Plus Insurers Collect a Monthly Premium Contribution From Families IMPLEMENTATION OF COST-SHARING

ArnoldView Graph # 8 CHILDREN ENROLLED IN CHILD HEALTH PLUS

ArnoldView Graph # 9 At What Income Level Should Premium Contributions Begin? What Amount of Cost-Sharing Is Both Affordable and Does Not Encourage Crowd-Out? How Should Premium Contributions Be Adjusted for Family Size? ISSUES IN LEGISLATIVE DEBATE ON PREMIUM CONTRIBUTIONS

ArnoldView Graph # 10 Most Utilization Control Is Left to the Managed Care Plan Copayments Are Used for Services Only Where Additional Utilization Controls Seem Necessary - Outpatient visits - Prescription drugs - Emergency room visits Implementation of Title XXI Limit on Out-of-Pocket Spending Is Creating Challenges EXPERIENCE WITH COPAYMENTS IN CHILD HEALTH PLUS

ArnoldView Graph # 11 Examine Enrollment by Income Level Analyze Utilization by Income Level Assess Reasons for Disenrollment Analyze Extent of Crowd-Out and Reasons for Dropping Private Coverage ASSESSING OUR COST-SHARING CHOICES

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