ACA Learning Series Mas Massac achusetts He Heal alth Car are - - PowerPoint PPT Presentation
ACA Learning Series Mas Massac achusetts He Heal alth Car are Train aining Forum Septemb mber er 15, 2014 014 Member Transition Strategy for Fall 2014 Open Enrollment Massachusetts ACA Learning Series The purpose of this ACA Learning
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residents, government, providers, insurers, business and community organizations
and more people are going to the doctor and getting treatment since Massachusetts enacted health care reform in 2006
(ACA) first Open Enrollment by working together and collaboratively with our federal partners and stakeholder coalitions, allowing us to provide alternative pathways to coverage and coverage extensions where necessary
health care coverage and has added to the ranks of the insured
t Open E Enroll llment p t period, leveraging the new hCentive platform that will make the application and enrollment process easier than ever for consumers, we have the task of reaching out to members, many of whom are in legacy or temporary coverage. We need to encourage them to take advantage of the ACA Open Enrollment and submit n t new appli lications f for c coverage ge begi ginning g in 2 2015.
programs including:
DO DO NOT need to submit a new application during the Open Enrollment period.
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Transiti tion P Populati tion Reach o
to p predominant nantly l y low-income r residents a and nd assist th those th that ne need to t transit ition f n from legacy/ y/temporar ary c coverag age to ACA-compli liant c cove verage* Remai aining ning Unin insured Bring ng as many o y of th them a as possible i int nto c coverage offered by y MassHealth o
the Health C Connect ctor Cur urrently I y Ins nsured & Newly S y Seeking ng C Coverage th throug ugh th the Health Conn nnector Allo llow t w them to a apply ly, , shop and e enroll b ll before re O Open E Enroll llment clo lose ses
*Includes existing QHP population needing to transition to the new system
For the upcoming Open Enrollment, our highest priority is to successfully transition current Health Connector and temporary MassHealth members in
Temporary Medicaid
~285K
CommCare ~100K
~ 34k
MH; some likely have and will keep ESI
premium and only nominal cost-sharing, which will no longer be the case for many
State Wrap
and costs of plans they will likely be eligible for
“Fast Path” last year
population but accustomed to renewals instead of new applications New Shoppers seeking coverage through the Marketplace
(# unknown)
QHP
Transition Population
Anticipate a number of people will not submit new applications because their circumstances may have changed and they may no longer require coverage through us.
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Challenges: Advantages:
− We have addresses for virtually all of them and phone numbers for approximately half of them
Harvard School of Public Health found 63 percent of respondents favor health care reform), supported by a strong coalition of partners
What We Achieved During Fall 2013 Open Enrollment
affirmatively applied for coverage despite IT problems
because: 1) member information on file is dated; and 2) the existing HIX system has significant data quality problems
and literacy barriers, is very passive and hard to engage
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Building upon the foundation from last year’s campaign, we will leverage high intensity, multi-faceted outreach strategies, with the goal of getting to every single person in need of coverage.
Direct Member Contact
Community Enrollment Assistance
Media and Public Education Foundation
coordinated messaging Centralized member outreach data reporting to track and measure our progress.
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informed by their proposed coverage end dates
paper applications to a subset of the population that might be more likely to apply by paper
− For Commonwealth Care and Medical Security Program (MSP) members, we will mail paper applications to ~35,000 individuals who did not reapply or who applied by paper last year, specifically those who may have language barriers or who have not had to pay a premium to remain in coverage − For temporary Medicaid members, we will mail paper applications in three waves (in line with their coverage end dates) to ~115,000-150,000 households that applied by paper last year. Final numbers will depend on the final count of individuals in temporary Medicaid (~285,030 members as of August 30, 2014) − We have also assessed the current workforce who enters these applications and will augment accordingly to mitigate paper backlogs and to ensure that applications get processed in a timely manner
way to apply for coverage this Open Enrollment is online
QHP/QDP CommCare/MSP Temporary MassHealth December 31, 2014 January 31, 2015 January 15, January 31, February 15 - 2015
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Direct Member Mailings
− Postcards to reinforce important dates and provide calls to action to sign up (Open Enrollment start date, plan selection and payment deadline dates, etc.) − Open Enrollment packets providing population specific messaging, frequently asked questions and details on where individuals can go to receive help applying and enrolling − E-mail blasts will follow each mailing to members for whom we have an e-mail on file − Operational letters and invoices sent to current members will also include language about Open Enrollment and important dates − To a certain subset of the subsidized population, paper applications (further detailed in later slide)
Outbound Call Campaign
phone calls before, during and after the Open Enrollment period
− Automated calls will be deployed to reinforce messaging provided in member mailings to all transition members. These can also be left on voicemail − Live agent calls will be deployed to provide education and enrollment support to transitioning members
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Oct October Novembe ber December Janua nuary Fe February
QHP HP (~34K 34K)
CommCa Care / / MSP SP (~100K) K)
Tempo porary Medica caid W Wave 1 1 (~100 100K) Tempo porary Medica caid W Wave 2 2 (~100 100K) Tempo porary Medica caid W Wave 3 3 (~100 100K)
Automated and Live Agent Outbound Calls (~2.3M calls deployed) Door Knocking Campaign (target 200,000 doors)
Preview Postcard Open Enrollment Packet Reminder Postcard Paper Application Coverage End Date
10/20 11/3 11/3 11/15 12/15 12/1 12/8 12/8 1/12 1/12 1/12 2/9 1/12 1/12 2/9 1/15 1/31 12/31 1/31 2/15 11/17
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Door Knocking Campaign
campaign designed to target 200,000 doors to inform consumers of the need to apply for 2015 coverage
have a variety of education and application materials to share with transitioning members Other Outreach Materials
information (updated income, benefit information where applicable etc.), as well as some new pieces based on feedback from our
differences between metallic tiers , the ConnectorCare program, student health insurance and options for individuals who are offered COBRA
stakeholders across the Commonwealth
In-person assistance in the community helps us convey that help is available when and where it is needed, especially to those consumers that are the hardest to reach.
Appli plication Couns nselo lors & & Navigators
− Certified Application Counselors (CACs), typically hospitals and other providers, offer assistance at the point of service, helping their patients apply for coverage, whether they are transitioning or new to health insurance − Navigators tend to be community-based organizations and community health centers that provide more general
munity Enrollme llment nt F Fairs
− We are organizing “enrollment fairs” across the state, staffed by Navigators, staff members from the state and
supported by our Navigators, health plans, community leaders and business partners
y Partner Collaboration
− Assisting Issuers with establishing enrollment centers and training their customer service staff on member transition efforts and new policies or programs − Anticipate co-hosting community events with local representatives and senators in districts with high concentrations of transitioning members − Collaborating with organizations specializing in outreach and consumer advocacy (see next slide)
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Navigators across the Commonwealth to assure residents that help is available when and where it is needed, especially for those consumers who are most vulnerable or the hardest to reach
regional and ethnic diversity within the program and expand coverage to underserved areas beyond last year’s Navigator program coverage
Year 1 Program Coverage Year 2 Program Coverage
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Navigator
Boston Public Health Commission Cambridge Economic Opportunity Council Caring Health Center Casa Latina Community Action Committee of Cape Cod & Islands Ecu-Health Care Family Health Care of Worcester Fishing Partnership Greater Lawrence Community Action Council Hilltown Community Health Centers Joint Committee for Children’s Health Care in Everett Manet Community Health Center Massachusetts Alliance of Portuguese Speakers People Acting in Community Endeavors Vineyard Health Access/County of Dukes County
Total Amount Awarded
This year’s Navigators offer a diverse array of outreach, education and enrollment activities and support.
15 Navigato tor organizations that span across Massachusetts. Training is underway for these groups and in November we will be introducing them to their communities via local media and press events
− Following completion of the first phase of training and passing the required exam, 85 Navigators have been certified − Phase 2 training is scheduled for September 25-26 and will focus on direct enrollment assistance and member transition activities
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We are again partnering with Health Care For All this year to continue its grassroots, public education campaign for the upcoming Open Enrollment period.
connect consumers with affordable, accessible and comprehensive health care
transitioning populations, Health Care For All is an obvious partner as we work to reach out to individuals in the coming months
and bring targeted outreach to a new level
Knock on 200,000 doors!
Provide online community support to enrollment assisters Ethnic/local media campaign targeting over 500,000 consumers
Legislative in- district briefings
Community- based trainings for assisters and outreach workers
Direct consumer assistance through the HCFA HelpLine
Materials in 7 different languages reaching over 250,000 consumers Support for strategic high- impact application and enrollment events
Presence at over 100 health fairs and educational events during Open Enrollment
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through a Navigator road tour and visits to other important regions, and includes op-eds and other written opportunities to earn coverage explaining OE and the call-to-action
in areas of significant member population
“I’m H Helping” g” Feature assisters in the community and keying in on the available resources to help viewers enroll “I A Appr pprove T This Messag age” A celebrity with local ties talks about being proud of health care reform and the need to take action “Re Real V Voices” Members tell their stories of applying last year and their desire to maintain coverage going forward “Benefits o
f Coverage” e” A lobsterman or someone else who faces hazardous conditions illustrates the need for coverage
Potential M Media T Theme mes
statewide, focusing on TV, radio, print in high-population areas, and digital (including video, search engine advertising and Pandora)
defining members’ knowledge
response to need to input information into a new system
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campaign will run throughout Open Enrollment, with heavier rotation through December, featuring Navigators giving a clear call-to-action to current members and
Navigator tour and education and enrollment events; media roundtables and demonstrations of the system; access to the Operations Command Center during the first stage of Open Enrollment
part of Health Care For All’s engagement, along with Navigator connections, building
Portuguese, Haitian and other ethnic
Working Television Story Board
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Public Education Events
mid-November featuring state officials, local health care experts and assisters, discussing the importance of health care and the need to submit a new application this fall
communities
public attendance
Enrollment Events
working with Navigators, carriers and other stakeholders to build awareness, foster our call-to- action and drive completion of online enrollments
eligibility for programs and information on insurance products offered. They will also be able to get assistance with an eligibility application, shopping and enrollment all in one place
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