Overview

Pennsylvania has one of the largest Health Insurance Premium Assistance Program (HIPP) "buy in" programs, with more than 21,000 members enrolled as of April 2004. The program, implemented in 1994, pays the worker's share of the premium for those eligible for Medicaid who have access to employer-sponsored health coverage. It achieved a savings goal of $76.3 million in FY 2003 (compared with providing direct Medicaid coverage for these people), which has been attributed to the following efficiencies: effective outreach involving building relationships with employers throughout the state, and an automated process for enrollment, tracking, and conducting analysis to determine whether enrollment in HIPP is less costly to the state than direct coverage. Its automated system interfaces with Department of Public Welfare (DPW) eligibility files, stores case records, and generates payments. Specifically, DPW collects information directly from employers, so that potential HIPP enrollees do not have to obtain and submit such information that is necessary to determine eligibility. Also, software capabilities allow administrators to identify necessary modifications in response to market/employment changes, and respond to inquiries in an efficient manner.

For more information

Web site: Pennsylvania Health Law Project http://www.phlp.org/education/hipp.html