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TECHNOLOGY STUDY FINDS THE VALUE IN A SIMPLE PHONE CALL

Analysis  |  By Eric Wicklund  
|   January 06, 2022


TOPICS

ACA
communication
health insurance
health plans
patient experience
research
technology


A STUDY PUBLISHED IN HEALTH AFFAIRS FINDS THAT A PHONE CALL WITH A CUSTOMER
SERVICE REPRESENTATIVE CAN BOOST HEALTH PLAN ENROLLMENT IN UNDERSERVED
POPULATIONS, INCLUDING THOSE AT OR NEAR POVERTY LEVEL, THE ELDERLY AND
MINORITIES.

Researchers have found that a phone call with a live person at the other end can
prod underserved populations in California into signing up for health insurance.



The study, led by Rebecca Myerson of the University of Wisconsin-Madison and
published this month in Health Affairs, finds that this simple bit of technology
can boost enrollment in the Affordable Care Act Marketplace among those at or
near the poverty level, as well as older Americans and minorities. Even with
this assistance, however, enrollment numbers remain low, and researchers said
these population still face several barriers to access.







Researchers studied roughly 79,500 consumers who had applied for coverage in
Covered California during the 2019 open enrollment period but had not selected a
plan, and found that a personalized phone call from a service center
representative boosted enrollment by 2.7 percentage points, or 22.5 percent of
the target population, amounting to an overall return on investment of 2:1.



“When a consumer was reached for a one-on-one telephone conversation, the
service center representative had detailed information on the consumer’s
available options,” Myerson and her colleagues reported in the study.
“Representatives were able to describe to consumers the subsidies and
cost-sharing reduction options for which they were eligible, clarify the
parameters of specific plans available to them (including the costs and benefits
of each plan, provider networks, and quality ratings), and walk them through the
enrollment process if desired. Assistance was available in Spanish and other
languages. This intervention could address enrollment barriers such as lack of
awareness of health insurance options, low health insurance literacy or computer
literacy, preference for in-language assistance, and the time and cognitive
costs of sifting through options.”



--------------------------------------------------------------------------------


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The project points to both the value and drawbacks of using technology to engage
consumers. Researchers noted that some forms of communication, such as automated
messaging, texts and e-mails, might not be appropriate or effective in reaching
target populations who aren’t comfortable with those channels, while a simple
phone can with a live voice at the other end can reach and effectively engage
some people.



“Several prior interventions sought to improve health insurance decisions via
‘low-touch’ outreach methods, such as presenting information in an automated
online choice environment, in an advertisement, or by mail,” the researchers
noted in the study. “Although these approaches are effective for many consumers,
they might not be sufficient to overcome certain barriers to obtaining coverage,
such as gaps in health insurance literacy, computer literacy, or internet
access. Further, consumers in non-English-speaking communities may face language
and informational barriers that limit the effectiveness of traditional passive
outreach. These concerns have led to increasing interest among policy makers,
navigators, and consumer organizations in developing novel outreach methods to
address diverse barriers to enrollment.”



The biggest take-away is that technology can work if it’s tailored to the
targeted population. A “one-size-fits-all” approach won’t work well.



Myerson and her colleagues found the personalized phone calls don’t overcome all
barriers but do result in ”modest by meaningful enrollment gains in certain
populations while yielding a positive return on investment.” They reported an
estimated cost per new member acquired at $224, similar to Covered California’s
average lifetime commission per member for broker-assisted customers.



They also suggested developing a long-term strategy that might include longer
interactions, passive nudges and reminders and even automatic enrollment.



Myerson was joined in this study by fellow UWM researcher Honglin Li, Nicholas
Tilipman of the University of Illinois at Chicago, Andrew Feher and Isaac
Menashe of Covered California and Wesley Lin of the University of California Los
Angeles (UCLA)







Eric Wicklund is the Technology Editor for HealthLeaders.







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TAGGED UNDER:

ACA
communication
health insurance
health plans
patient experience
research
technology

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