Separate State Plan Advantages and
Disadvantages
Although start-up of a separate State SCHIP program can be slow and will require
development of new data systems, networks, and contracts, there are advantages of
implementing a separate State program, including:
- Flexibility in setting reimbursement rates; Provider rates can be higher than Medicaid
and still affordable to the State.
- Less stigma associated with serving higher income groups and new program
name—program is seen as mainstream health insurance.
- Increased network flexibility. HMOs can use either their Medicaid provider network or
their commercial network.
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