Benefit Design - Service Delivery - Separate State Plans

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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 to 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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SCHIP Guidance - Strategies Suggested by Presenters

What led to this?

Assessing Key Issues with Service Delivery

Who presented this material?

Shelly Gehshan, M.P.P. and Denise Holmes

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