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PUBLIC PAYERS NEWS


PERSONALIZED PHONE CALLS, EMAILS BOOSTED ACA ENROLLMENT RATE IN CA


WHILE EMAIL REMINDERS ALONE DID LITTLE TO IMPROVE ENROLLMENT, EMAILS COUPLED
WITH PERSONALIZED PHONE CALLS INCREASED THE ACA ENROLLMENT RATE BY 47 PERCENT
FOR FORMER MEDICAID BENEFICIARIES IN CALIFORNIA.

Source: Getty Images

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By Victoria Bailey



October 20, 2022 - Personalized phone calls combined with email reminders were
an effective outreach method for former Medicaid beneficiaries transitioning to
Affordable Care Act (ACA) coverage, as the approach led to a 6.9 percentage
point increase in California’s ACA enrollment rate, a JAMA Health Forum study
found.

When the COVID-19 public health emergency expires, around 15 million Medicaid
beneficiaries are projected to lose coverage due to redetermination processes
and administrative churning.

Many of those who will lose Medicaid eligibility will be eligible for ACA
marketplace subsidies, providing an alternative opportunity for coverage.

DIG DEEPER

 * Subsidies Drive Individual Health Insurance Marketplace Enrollment
 * How Phone Calls Impact Affordable Care Act Marketplace Enrollment
 * Behaviorally Informed Letters Boost Affordable Care Act Enrollment

Researchers focused on 2,173 Californian households that recently lost Medicaid
coverage and became eligible for subsidized marketplace coverage during a
special enrollment period in 2017. They assigned the households to one of four
groups to determine which outreach method impacted enrollment in Covered
California, the state’s ACA marketplace.

The first group was the control and received no outreach except for the required
eligibility determination notice provided based on households’ communication
preferences. The second group received the required notification and email
reminders about enrolling in marketplace coverage.

The third group received the required notice plus a personalized phone call
offering enrollment assistance from a service center worker. The final group
received the required information, email reminders, and a personalized phone
call for enrollment assistance.

In November 2017, researchers used the Covered California administrative
database to determine whether a household enrolled in marketplace coverage
during the special enrollment period. They found that just 14.5 percent of the
control group enrolled in Covered California, indicating that the required
notice alone did not significantly improve enrollment.

Similarly, receiving the required notice plus email reminders did not increase
the enrollment rate and led to a -0.5 percentage point decrease.

Personalized phone calls were more effective, increasing the enrollment rate by
4.4 percentage points or 30 percent. The email reminders combined with
personalized phone calls had the most significant impact on enrollment, boosting
the enrollment rate by 6.9 percentage points or 47 percent.

The results suggest resource-intensive strategies will be necessary to
facilitate transitions from Medicaid to ACA marketplace coverage once the public
health emergency ends.

A Health Affairs study from January 2022 also found that personalized phone
calls helped improved ACA enrollment rates for Californians. Individuals who
received a phone call had a higher enrollment rate by 1.3 percentage points or
10.8 percent compared to the control group that did not receive a call.

Behaviorally informed letters have also boosted ACA enrollment for people
seeking healthcare coverage on HealthCare.gov. One study found that low-cost
letters catering to different behavioral dynamics successfully increased
marketplace enrollment by up to 1.6 percentage points.

Subsidized coverage on the ACA marketplace has contributed to growing enrollment
in the individual health insurance marketplace. In the first quarter of 2022,
around 16.9 million people enrolled in coverage on the individual health
insurance marketplace, marking the highest rate since the first quarter of 2017.


 * Tagged
 * Affordable Care Act
 * Medicaid
 * Member Engagement

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