Colorado Health Insurance Exchange Consumer Focus Groups Adela Flores-Brennan Colorado Center on Law and Policy x313

Background  First phase of a five phase project to engage consumers in implementation of the COHBE  Multiple partners (CCLP, CCHI, CoPIRG, John Snow, Inc.)  Targeted individuals without large group coverage  Targeted individuals with incomes from 133 up to 400 percent of the Federal Poverty Level (FPL)

Methodology  Qualitative data gathering through targeted focus groups  Varied geographic participation (rural and urban)  Three tiered recruitment process  Screening process prior to participation  Focus groups were conducted using consistent guidelines

Process  Focus groups occurred throughout Colorado (one interview)  Denver, Grand Junction, Sterling, Greeley, Pueblo  One Denver focus group in Spanish  70 participants in eight focus group sessions (participation ranged from four to 19 per session)  Diversity in gender, age, race, ethnicity, education, and income were represented

Issues explored  Expectations  Choice  Access  Integration  Appeal and marketing

Findings: Expectations  The Exchange should be easy to use, allowing quick and understandable comparisons of similar aspects of different health insurance plans.  The Exchange should contain costs.  The Exchange should ensure a high level of accountability and transparency.  The Exchange should be an unbiased source.  The Exchange should help consumers understand difficult concepts and should provide for consumer reviews.

Findings: Choice  Participants interpret the concept of choice in very different ways.  The Exchange should provide highly individualized selection based affordability, family size and/or health care needs.  Selections pulled from a wide range of choices.  Cost is primary selection criteria followed by benefits.  Geographic variation: western slope wanted more options within region; in Sterling participants wanted to go outside region.

Findings: Integration  Some mixed opinions about accessing public benefits.  Most think it makes sense to direct consumers to Medicaid eligibility if appropriate.  Less consensus on other public benefits— some thought it would be a good service for customers, others thought it was beyond the scope.

Findings: Access  Most would access the Exchange on line, but  Live, on phone or in person support from highly knowledgeable individuals is critical.  Opinions varied as to who people trust to help them navigate their Exchange experience.

 Effective, frequent, culturally appropriate and varied marketing techniques will play a key role in ensuring that individuals are aware of the Exchange.  Consistent, prominent, frequent messages.  Trusted messengers: providers, clinics, schools, libraries and community organizations for information. Findings: Marketing/Outreach

 Tax credits that help pay for premium or help customers buy up will attract customers.  Ease of use promise will attract customers.  Highly tailored plan options will attract customers.  Successful experiences will generate good work of mouth and attract customers.

Marketing/Outreach: book mobiles and digital TV  Ideas for reaching customers:  Analog to digital  Book mobiles  Health care access points  Community forums/”career fairs”  Broadcast Exchange information hour