BURLINGTON, Mass., July 2, 2014 /PRNewswire/ -- Decision Resources Group finds that the Indianapolis market is in significant flux as it implements several key initiatives of the Affordable Care Act, including accountable care organizations and Medicaid eligibility expansion. One of Indianapolis' largest ACOs, the Indiana Accountable Care Consortium (ACC), is being dissolved less than two years after its launch because the changes required by healthcare reform were too daunting for the participating provider organizations to complete as a combined organization. The state also intends to seek a Medicaid expansion alternative using an altered version of its Healthy Indiana Plan (HIP) that would replace traditional Medicaid in Indiana for all non-disabled adults.
Members of the Indiana Accountable Care Consortium—St. Vincent Health, Community Health Network and Suburban Health Organization—contracted to be in competing narrow networks offered by health plans participating in the state's health insurance exchange in the Indianapolis market, which likely contributed to the dissolution of the ACC.
The joint operating agreement between Community Health Network and Eskenazi Health—a partnership that would have created a primary-care behemoth in the market—is also being called off.
Gov. Mike Pence's Medicaid expansion proposal would allow Indiana to use federal Medicaid funds to enroll residents with incomes up to 138 percent of the federal poverty level in a program called Healthy Indiana Plan 2.0. HIP Plus, one of the three options that would be offered under HIP 2.0, would use the consumer-driven health plan model and require monthly contributions to a health savings account. HIP 2.0 would include a comprehensive prescription drug benefit.
Pending federal approval of Indiana's Medicaid waiver, implementation of the Healthy Indiana Plan 2.0 would eliminate the coverage gap for hundreds of thousands of residents whose incomes are too high to qualify for Medicaid and too low to qualify for federal subsidies for plans offered through the state health insurance exchange.
Comments from Decision Resources Group Analyst AnnJeanette Colwell:
"ACO formation in Indianapolis has been led by the health systems, and although the Accountable Care Consortium is being dissolved, participating health systems are likely to launch ACOs on their own."
"Indiana's Medicaid expansion proposal would benefit Indiana hospitals because the number of uninsured residents would significantly decrease. The proposal is also likely to increase prescription drug utilization because the HIP 2.0 plan options include drug coverage."
AnnJeanette Colwell has written a blog on the subject, which can be found here.
Decision Resources Group's Indianapolis ACO Spotlight Series report has also been updated to reflect ACO developments described above.
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