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印第安纳州的第1115条医疗补助豁免条款和跨部门协调改善了涉司法成年人的参保情况。

Indiana's Section 1115 Medicaid Waiver And Interagency Coordination Improve Enrollment For Justice-Involved Adults.

作者信息

Blackburn Justin, Norwood Connor, Rusyniak Dan, Gilbert Amy Lewis, Sullivan Jennifer, Menachemi Nir

机构信息

Justin Blackburn (

Connor Norwood is the chief data officer in the Indiana Family and Social Services Administration, in Indianapolis, Indiana.

出版信息

Health Aff (Millwood). 2020 Nov;39(11):1891-1899. doi: 10.1377/hlthaff.2019.01823.

DOI:10.1377/hlthaff.2019.01823
PMID:33136497
Abstract

Timely access to Medicaid coverage offers many potential benefits to justice-involved adults reentering the community. In 2015 Indiana's Section 1115 Medicaid waiver (the Healthy Indiana Plan [HIP]) expanded eligibility for low-income adults. To expedite coverage for justice-involved adults, Indiana subsequently improved interagency coordination in two ways. First, the Indiana Department of Correction began initiating Medicaid applications for those in custody. Second, Medicaid began temporarily suspending coverage for people while they were incarcerated instead of discontinuing it. Prison release data from the Indiana Department of Correction linked to Medicaid enrollment data indicate that before HIP was implemented, approximately 9 percent of justice-involved adults received Medicaid coverage within 120 days of release. After HIP implementation, coverage rates increased by 9 percentage points. After both interagency coordination policies were implemented, an additional 29-percentage-point increase in coverage occurred. Furthermore, coverage effective within seven days of release increased by 14 percentage points after the interagency coordination policies went into effect. These findings support the notion that policies and procedures encouraging interagency coordination are beneficial in increasing timely access to Medicaid coverage for justice-involved people.

摘要

及时获得医疗补助覆盖范围为重新融入社区的涉司法成年人带来了许多潜在益处。2015年,印第安纳州的第1115条医疗补助豁免条款(即“健康印第安纳计划”[HIP])扩大了低收入成年人的资格范围。为了加快涉司法成年人的覆盖范围,印第安纳州随后通过两种方式改善了跨部门协调。首先,印第安纳州惩教部开始为被监禁者提交医疗补助申请。其次,医疗补助部门开始在人们被监禁期间暂时中止其覆盖范围,而不是终止。印第安纳州惩教部的监狱释放数据与医疗补助登记数据相关联,结果显示,在HIP实施之前,约9%的涉司法成年人在释放后的120天内获得了医疗补助覆盖。在HIP实施后,覆盖比率提高了9个百分点。在两项跨部门协调政策都实施后,覆盖范围又额外增加了29个百分点。此外,在跨部门协调政策生效后,在释放后七天内有效的覆盖范围增加了14个百分点。这些发现支持了这样一种观点,即鼓励跨部门协调的政策和程序有助于为涉司法人员更及时地获得医疗补助覆盖范围。

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