ACHIEVING HEALTH CARE COVERAGE SUCCESS IN 2014 AND BEYOND: Stakeholder Input on Strategies for Marketing, Eligibility, Enrollment and Retention Katie Marcellus.

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Presentation transcript:

ACHIEVING HEALTH CARE COVERAGE SUCCESS IN 2014 AND BEYOND: Stakeholder Input on Strategies for Marketing, Eligibility, Enrollment and Retention Katie Marcellus California Health Benefit Exchange Board Meeting March 22, 2012

California Health Benefit Exchange 1 Marketing, Outreach, Enrollment and Retention Input Process Channels for input Written comments Small group sessions Stakeholder comment letters and reports Exchange Board meetings Next steps for incorporating input Development work being conducted by Ogilvy and RHA Exchange Board program and policy planning

California Health Benefit Exchange 2 Marketing, Outreach, Enrollment and Retention Input Process Small group sessions Small group sessions convened by the Exchange, Department of Health Care Services, Managed Risk Medical Insurance Board and Office of the Patient Advocate 17 sessions convened around the state Separate sessions convened for consumer advocates, providers, county representatives and brokers Participants serve or represent over 25 California urban and rural counties Written comments Written comments submitted by over 30 individuals and organizations

California Health Benefit Exchange 3 Stakeholder Perspectives on Success Successful coverage expansion Focus on core competencies needed for successful launch in 2014 Recognize Exchange should expand focus over time to delivery system reform, health improvement and linkages to other programs Enrollment success Estimates ranged from 20% of eligible individuals enrolled by the end of 2014 to 100% by the end of 2019 Affordability of products, effective outreach and simplicity of enrollment systems will impact success

California Health Benefit Exchange 4 Stakeholder Perspectives on Marketing, Promotion and Outreach Strategies for reaching target populations Understand the priorities of target populations Tailor marketing and outreach to target populations Use clear and simple messages Key considerations Prioritizing marketing and outreach efforts Timing for marketing and outreach Beware not being seen as “another government program” Need for balanced risk pool Connection with human services

California Health Benefit Exchange 5 Stakeholder Perspectives on Marketing, Promotion and Outreach Top outreach and marketing activities Tell the stories of real people Leverage existing, trusted community networks Use social media to reach young adults Work with schools to encourage coverage Work with colleges and universities to reach young adults Use ethnic media Give providers outreach tools Tailor outreach strategies for rural communities Tailor outreach strategies for small businesses Other marketing and outreach strategies to explore Special marketing and outreach for SHOP

California Health Benefit Exchange 6 Stakeholder Perspectives on Marketing, Promotion and Outreach Strategies to maximize early enrollment Maximize use of auto- or pre-enrollment (e.g., LIHP, Family PACT) Maximize enrollment in insurance affordability programs by working with entities that serve potentially-eligible individuals (e.g., DMV, schools, Franchise Tax Board) Maximize enrollment among individuals who use health services by working with providers

California Health Benefit Exchange 7 Stakeholder Perspectives on Marketing, Promotion and Outreach Need strategies to Maximize Retention Simplify program rules Access to care critical to affirming value of coverage Effective Messengers and Messages Stories from people who benefit from coverage expansion Trusted community leaders provide clear and consistent messages

California Health Benefit Exchange 8 Stakeholder Perspectives on Enrollment Assistance, Navigators and Health Insurance Agents Perspectives on entities’ roles in providing enrollment assistance Balance the need for in-person assistance with cost Need all hands on deck Different groups start with different core competencies Counties – public program eligibility Consumer groups – public program eligibility and benefits Brokers – private plans and benefit design variation Use existing trusted sources Diversity of perspectives on roles

California Health Benefit Exchange 9 Stakeholder Perspectives on Enrollment Assistance, Navigators and Health Insurance Agents Supporting applicants across the continuum of assistance Key considerations Need for assistance will change over time Be ready for high need in early years Need to clarify scope of assistance (eligibility to enrollment to use of care to retention) Self-servicePhone AssistanceIn-person Assistance (web or mail)

California Health Benefit Exchange 10 Stakeholder Perspectives on Enrollment Assistance, Navigators and Health Insurance Agents Methods of payment for enrollment assistance No payment Flat application payments Grants Premium-based commissions Key considerations No “one size fits all” payment system Consider hybrid payment models (e.g., flat payments and grants) Requirements and performance standards Need for rigorous initial and ongoing training and strong performance standards

California Health Benefit Exchange 11 For More Information: Visit our stakeholder webpage at