By John J. Wernert, MD, Secretary, Indiana Family and Social Services Administration
Indiana physicians will love the expanded Healthy Indiana Plan. And here’s why: Long before Washington gave us the Affordable Care Act, Indiana played a pioneering role in another, well-established health care reform movement: consumer-directed health care.
The concept was simple: to give people the same freedom to manage their health care that they have in managing other parts of their lives, and give them incentives to take ownership of their health decisions. Doing so will improve engagement and lead to better health and cost-conscious decision making. Consumer-directed health care has become commonplace in the commercial insurance market and embraced by health care providers. It’s also a concept that Indiana – and only Indiana – has applied successfully to a state-run health coverage program for low-income residents for the last seven years.
Before taking on the role of FSSA secretary, I spent decades as a practicing physician in Indiana. Like most physicians, I like to see my patients in a program that engages them and gives them incentives to take better care of themselves.
The Healthy Indiana Plan, with its consumer-directed principles, does this.
Before getting deeper into what the Healthy Indiana Plan is, let’s plainly state what it is not. It is not Medicaid. Medicaid is an entitlement program that encourages people to do exactly what it requires of them – nothing. It is also a program that doesn’t work for health care providers from a business standpoint because of its practice-crippling reimbursement rates. Because of this, many of my colleagues are faced with the tough choice of refusing to provide care to our poorest citizens.
While some Medicaid programs will continue to be there for our most vulnerable (the aged, blind, disabled and children) Governor Pence’s “HIP 2.0” proposal will provide 350,000 additional Hoosiers who are currently uninsured with a chance to participate in a health coverage program with real incentives to take charge of their health and be cost-conscious consumers.
For physicians like me, consumer-directed health care is not merely a theory or a philosophy. It represents a real, positive culture shift we see occurring with our patients in commercial plans right now. In my practice I have seen the positive impacts of having more engaged patients and incentivizing things like preventive care. The Healthy Indiana Plan has been well received these past seven years by the health care community in Indiana and by its members. HIP 2.0 would expand on something that is very favorable.
Personal responsibility is a big deal to us doctors. Physicians like me want to get people back to good health and back to work. We know that if you empower people to make good choices about their health and wellness, good things will happen.
As a Medicaid provider for the past 25 years, I have not seen the same shift toward better health engagement among Medicaid patients that I have with my commercial patients.
The incentive is just not there. Because of the paltry reimbursement structure, the incentive is not there for doctors to even see these patients. The HIP 2.0 proposal solves this, not only by reimbursing providers much more for the care they provide to Healthy Indiana Plan members, but also for the care they will continue to provide to Hoosiers in our Medicaid programs. This will help to ensure a robust provider network.
Governor Pence is not interested in creating or expanding a long-term, expensive entitlement program that doesn’t work for doctors and won’t help Hoosiers get healthy or be more prosperous. He wants to give the uninsured a chance to improve their health – not a simple handout – and give our fellow Hoosiers a real sense of health security.
The Healthy Indiana Plan has been endorsed by the Indiana State Medical Association, the Indiana Primary Health Care Association and the Indiana Hospital Association. It is clearly a health improvement program we doctors can get behind.