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SETTING COST SHARING GUIDELINES LESSONS LEARNED. Since Its First Enrollment Healthy Kids Has Experienced Increases and Decreases in Premiums Paid by Families During This Time, Copayments and Benefits Remained Consistent

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setting cost sharing guidelines lessons learned
SETTING COST SHARING GUIDELINESLESSONS LEARNED
  • Since Its First Enrollment Healthy Kids Has Experienced Increases and Decreases in Premiums Paid by Families
  • During This Time, Copayments and Benefits Remained Consistent
  • The Effect Each Change in Cost Sharing Has Had on Enrollment Has Been Evaluated by the Corporation
slide4

COST SHARING

Family Contributions To Monthly Premiums

slide6

ENROLLMENT BY SUBSIDY LEVEL

A Comparison of Enrollment when Full Subsidies are Available

After one year of enrollment

slide7

ENROLLMENT AS PERCENTAGE OF POPULATION

Percent of School-Age Children who Enrolled in Healthy Kids

After one year of enrollment

slide8

HEALTH CARE UTILIZATION

  • Families Who Contributed the Monthly Premium Were Twice As Likely to Access Health Care Services As Those Who Were Not Required to Pay a Monthly Premium
  • It Was Determined From This That Families Who Contribute at Least Some Portion of the Monthly Premium Are More Likely to Access Health Care
slide9

ENROLLMENT BY SUBSIDIZED COVERAGE

After Increase in Monthly Premium

10,000

August September

slide10

ENROLLMENT IN VOLUSIA COUNTY

After Increase in Premium

slide11

EFFECT OF PREMIUM INCREASE ON ENROLLMENT

VOLUSIA COUNTY:FULLY-SUBSIDIZED PREMIUMS WERE INCREASED TO $15 PMPM

  • Families in the Fully-Subsidized Category Were More Likely to Disenroll
  • These Families Were More Likely to Re-Enroll Their Children After 2 or 3 Months of Dropping Coverage
slide12

DISENROLLMENT

  • When a Monthly Premiums Were Increased for All Families, 39% of Participants Disenrolled From the Program:
    • 80% were previously fully-subsidized
    • 20% received a partial or no subsidy

AS A RESULT OF INCREASE IN FAMILY PREMIUM PAYMENTS

slide13

HEALTH SERVICES ACCESSED

  • 80% of Families Who Contributed to the Monthly Premium Accessed at Least One Health Care Service Within 12 Months of Enrollment
  • 55% of Families Who Were Not Required to Pay a Monthly Premium Accessed at Least One Health Care Service Within 12 Months of Enrollment
slide15

EFFECTS OF REDUCTIONS IN COST-SHARING

  • The Change in Enrollment After the Premium Decreases Is Minimal
  • Additional Time and Data Will Be Needed to Assess the Full Impact These Changes Will Have on Enrollment

AFTER AN INITIAL LOOK