2003 findings with survey instrument - Shadac

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This committee is charged with developing a comprehensive primary care strategy for theState of Indiana that targets residents with difficulty accessing care: those that are locatedin the inner cities, isolated in rural areas, and migrant farm worker communities.This committee will focus on specifically addressing the alternative payment system forFQHCs, but will also address broader policy issues for the Indiana Safety Net.B. Leveraging Federal Resources through Local InitiativesThe State of Indiana budget continues to face major deficits, and the Legislature in its lastsession, flat lined the Medicaid budget, which amounts to a budget cut with theincreasing number of Medicaid eligible persons in Indiana. This has made the challengefor the HIIF committee quite significant, as not only are there no dollars to work with,there also appears to be a lack of political will to address the uninsured in Indiana. Thiscommittee is focused on how federal funding can be leveraged through existing fundingstreams, without increasing the State budget. This Committee will examine optionsavailable through the Medicaid program. This Committee will explore current localfunding streams, as well as the various options available through recent changes on thefederal level to the Medicaid program. There is specific interest in exploring HIFAwaivers. This Committee will also have a broader focus on examining all potentialresources at the local and state level and ways to increase the federal funding in Indianato expand coverage. Currently the committee is composed of the Indiana Primary HealthCare Association (IPHCA), the School of Medicine, representatives from federallyqualified health centers, and the Department of Health.C. Options for Small BusinessesAs Indiana has a large number of small employers, who do not offer insurance, thiscommittee will focus on specifically developing options to encourage small businesses tooffer and finance health insurance. The Committee is currently composed of the CEO ofone of the major insurance companies in Indiana, the State Chamber of Commerce, theNational Federation for Independent Businesses, and the Department of Insurance. Thisdiverse team is very interested in developing solutions and has just begun to consideroptions. They are exploring such possibilities as employer and employee subsidies,purchasing pools, and tax credits. They are also examining the State’s high-risk pooland reinsurance options to lower costs for all businesses, but with a special focus onsmall businesses. Programs, such as the one implemented statewide in New Mexico andin counties in Michigan, where employees pay 1/3 of the premium (through payrolldeductions), employers pay another 1/3, and the final 1/3 is subsidized is also beingexplored.D. Provider Incentives & Project AccessDuring the 2003 legislative session, HB 1643 was passed. This legislation calls for theState to assist with the implementation of Project Health and specifically for FSSA toconduct eligibility for the program, and a not-for-profit to operate the plan. ProjectHealth is a volunteer physician program similar to programs implemented in Kentuckyand South Carolina, or the local based program in Buncombe County, North Carolina.Physicians agree to provide services to medically indigent patients, and pharmaceuticalvi
companies also dispense free pharmaceuticals to patients, courtesy of bulk replacements.The HIIF committee has been identified as a vehicle to develop the program, as manymembers are key stakeholders. Therefore, the HIIF committee will be developing acommittee to identify key implementation issues, and help coordinate the implementationof the program across the State. There are many policy issues to contend with includingtarget group, benefits, and local coordination, as well as getting providers to participate,and fundraising for on-going administrative costs. Representative Hasler, who sponsoredthe legislation, is coordinating most of these efforts, and he is very keen on having HIIFsupport the process, and to offer recommendations in the development of the program.SPG staff has also worked to coordinate some of the efforts already going on in the Statearound this type of program. There are at least two Community Access Program grantsthat have started to implement these programs, and an effort of the nationally basedHudson Institute to initiate such a program within Indianapolis and Marion County. TheHudson Institute has interests in working with Representative Hasler and Project Health.Those conversations are on going, and have been coordinated by SPG staff.E. StrategiesWith the recent activity of the legislature which did not support increases to the Medicaidprogram, and in fact flat lined the program, the HIIF members were keenly aware that afocus on raising awareness and support for the issues of the uninsured is needed. Whileall the committees will focus on the strategy to implement their options, this committeewill focus more specifically and broadly, on how the HIIF committee can work to createpolitical will to address the uninsured. This committee will also address the long-rangeplanning for the uninsured and consider making recommendations to address the healthsystem issues. The Strategies Committee will also provide recommendations for thetownhall meetings that will occur per our project plan in 2004.Section 5: Consensus & Building Strategy5.1 The Indiana Family and Social Services Administration serves as the State PlanningGrant recipient and also provides key leadership to the project. The Governor's Office hasassigned a contact person from the Governor’s Office to represent him in thedeliberations of the HIIF. FSSA staff contributes to the project, as well as outsideconsultants. The project is guided by the Health Insurance for Indiana Families (HIIF)Committee, a task force appointed by the Secretary of FSSA, which includesrepresentation from: large and small employers (National Federation of IndependentBusinesses, and the State's Chamber of Commerce), insurance agencies, physicians(Medical Association) hospitals (Hospital Association, as well as some hospitalAdministrators), safety net providers, including federally qualified health centers,consumer advocates, the Indiana Minority Health Coalition, Medicaid managed careorganizations, and the State's only Medical School. The Department of Health and theState's Department of Insurance also have representation on the HIIF committee. At thistime we have not included any legislators as HIIF members, but there are efforts to keepkey legislators aware of HIIF's activities, through key informant interviews, and otherbriefings. The goal has been to use this broad-based approach to include many diversevii
Page 1 and 2: "Peoplehelping peoplehelpthemselves
Page 3 and 4: EXECUTIVE SUMMARYThe State of India
Page 5 and 6: Focus Groups:Under our proposal, we
Page 7 and 8: Table 1 Indiana’s Uninsurance Rat
Page 9 and 10: was regarded as ineligible if he or
Page 11: The HIIF committee is also aware th
Page 15 and 16: uninsured, there is a need to concu
Page 17 and 18: Appendix II.Results of the Househol
Page 19 and 20: Why Don’t Uninsured Individuals P
Page 21 and 22: AcknowledgementsThis report was wri
Page 23 and 24: Finally, a number of themes emerged
Page 25 and 26: Studying health insurance coverage
Page 27 and 28: Estimated rates of uninsurance vary
Page 29 and 30: Table 2-2. Indiana’s Uninsurance
Page 31 and 32: Table 2 -4. Uninsurance Rates in In
Page 33 and 34: Figure 2-2 depicts uninsurance rate
Page 35 and 36: Table 2 -6. Indiana’s Uninsurance
Page 37 and 38: Why Don’t Uninsured Individuals P
Page 39 and 40: Figure 3-3. Percentage of Individua
Page 41 and 42: Table 4 -1. Distribution of Health
Page 43 and 44: Chapter 5What is the Employer Cover
Page 45 and 46: Employees of firms offering health
Page 47 and 48: Finally, the state of employer cove
Page 49 and 50: Table A1 Indiana Bio-terrorism Dist
Page 51 and 52: Table A1 Indiana Bio-terrorism Dist
Page 53 and 54: exchange) grouping is assigned to t
Page 55 and 56: The goal of post-stratification is
Page 57 and 58: Implementation of the Hot DeckWe im
Page 59 and 60: S5. What is your zip code? ___ ___
Page 61 and 62: IF TARGET AGE =< 2 YRS ?GOTO S12S11
Page 63 and 64:
H12 c1 PREM1 How much do you pay ea
Page 65 and 66:
The next questions concern health i
Page 67 and 68:
“LONG FORM” questions are avail
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UNIN2 And what is the main reason y
Page 71 and 72:
9. RefusedCOV4 If that family membe
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2. No7. Don’t know8. Parents/Guar
Page 75 and 76:
3. 10-25 miles4. 26-50 miles5. 51-1
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LIMIT.Do you have any of the follow
Page 79 and 80:
2. No7. Don't know/Not sure9. No an
Page 81 and 82:
5. More than 5 years7. Don’t know
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HHRACE3 . Of those, which do you co
Page 85 and 86:
3. Not Target’s # SKIP TO PHONE37
Page 87 and 88:
END OF SURVEY.THANK YOU FOR YOUR CO
Page 89 and 90:
more young males than females (less
Page 91 and 92:
Medicaid and Other Health Care Prog
Page 93 and 94:
Appendix DStatistical Significance
Page 95 and 96:
Table D-2 Demographic Characteristi
Page 97 and 98:
Survey Results by AgeFigure D-1. So
Page 99 and 100:
Table D-7. Employment Status of the
Page 101 and 102:
Table D-8. Uninsurance Rates in Ind
Page 103 and 104:
Table D-10. Employment Status of Wh
Page 105 and 106:
Madison82
Page 107 and 108:
Table D-13. Demographics Characteri
Page 109 and 110:
Geographic AreaProportion of Uninsu
Page 111 and 112:
Characteristic Region 1 Region 2 Re
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2003 findings with survey instrument - Shadac

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