state of enrollment: lessons learned and the way forward

State of Enrollment Report: Lessons Learned and the Way Forward

July 10, 2014

Agenda

Welcome Sophie Stern Deputy Director, Best Practices Institute

Digital Outreach and Analytics

Adam Stalker National Digital Director

Grassroots Organizing and Earned Media

John Gilbert National Field Director

The Power of Collaboration Jose Plaza National Latino Engagement Director

Key Takeaways and Q&A Sophie Stern Deputy Director, Best Practices Institute

Who Are We?

Two-‐fold Strategy

Our Mission

Maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act

Promo&ng Enrollment Best Prac&ces

Na&onal Enrollment Campaign Using Cu7ng Edge Engagement Strategies

67% of the uninsured lived in 13 states and 50% lived in just 113 counties

Available on-line here https://s3.amazonaws.com/assets.getcoveredamerica.org/20140613_SOEReportPDFlr.pdf

Lessons Learned through Enroll America’s Get Covered America Campaign & Partner States

Individuals Connected to New Coverage Options

Agenda

Why A Digital Focus?

•  Meeting consumers where they are

o  91% of Americans own mobile phones

o  87% actively use the internet

•  It’s where they get news and information

o  More women than men on social media

o  Latinos and African Americans over index for

social media

•  Digital is more cost effective

Digital Topline Results

1.85 million unique users

1.1 million consumer email addresses

5 million page views

380,000 people connected to marketplace or assistance

Sample Online Banner Ads

Digital Paid Media Overview

•  1.1 million email addresses •  Digital paid media was responsible for

more than 87% of all email acquisition

•  Efficiencies improved by 95% after shifting paid media strategy in early Q4 to geo-targeting ZIP codes with highest rates of uninsured instead of trying to target uninsured consumers online

12.61%

66.36%

11.11%

2.42% 1.91%

Email Acquisition by Source

Earned Sources

Lead Gen

Paid Search

Text Links

Display/Banner

Paid Social

Source: Enroll America Digital Program

Improving Efficiencies Of Paid Media

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

1,000,000 1-

Campaign CPA Consumer Emails

12 Source: Enroll America Digital Program

Consumers Are Mobile

Compared to the general internet audience, Get Covered America’s audience over-indexed heavily for smartphones – almost 5.4x the internet average.

And 45% of site traffic came from mobile devices.

(0.33)

(2.00)

(1.00)

Enroll America

Devices used to connect to internet

55% 36%

Devices used to connect to GCA.org

Desktop

Mobile

Tablet

Who Was Our Typical Consumer?

•  The audience most likely to connect from GetCoveredAmerica.org to their state marketplace*: •  Adults 25-44 and 55-64 •  Household income $15k-$49k •  Single, Females

*Data from one display media partner but results consistent with other partners

Urgency Changed Over Time

•  Consumers that connected to their Marketplace in Q4 2013 displayed “early mover” characteristics by connecting to their Marketplace after being on the GCA email list for 8 days

•  Compare that to consumers that took 33 days to connect to their Marketplace in March and April 2014, more than 3x as long as those in Q4 2013

Q4 2013 Jan 1-Feb 28 2014 Mar 1-Apr 15 2014

Average # of days on email list before connecting to Marketplace

Follow Up Through Multiple Mediums

0.00% 1.00% 2.00% 3.00% 4.00% 5.00% 6.00% 7.00%

Overall

Phone & Email

Phone Only

Improvement in Enrollment Rate in the Last Month Among Uninsured Caused by Follow-Up Program

Source: Enroll America Digital Program

Lessons Learned: Digital Message Testing

1.  Personal stories didn’t resonate as well as individualized help

2.  “Affordability” was the biggest driver of engagement, but some messages are better than others: o  Be specific, include dollar figures o  Don’t talk about savings, use real

examples of monthly cost o  “Salesy” language was a deterrent

3.  The fine was a strong motivator 4.  Avoid political or non-profit fundraising

style language – this is a consumer marketing campaign

Examples of Winning Messages

•  “Free, in-person help with your

health insurance application.”

•  "Gail R. from Pennsylvania got

covered for $1.11 per month.”

•  ”Over half of uninsured Americans could get

covered for less than $100 a month.”

•  “Sign up by March 31st to avoid

paying a fine.”

Agenda

Grassroots Organizing And Earned Media

Enroll America state staff focused on building an organization comprised of volunteers and partners, working within local coalitions that could accomplish two goals:

1. Engage consumers directly around enrollment and link them directly to enrollment assistance

2. Create earned media opportunities around enrollment education

Volunteer And Shift Growth

Source: Enroll America Field Program

Event Participation Growth

•  [Insert text]

Consumer Outreach

Commit Cards Signed By Consumers

Increase In Enrollment Rate After Multiple Contacts

Contact Increased Enrollment

Overall" African American" Latino" Youth"

Growth in Enrollment Rate by Number of Volunteer Follow-Ups!

After First Follow-Up" After Second Follow-Up" After Third Plus Follow-Up"

Enrollment Event Growth

Different Consumer Leads From Digital And Field

Source: Enroll America Field & Digital Program

Access to a national database of consumers •  Access to target outreach efforts for door to door contact or tabling events Produce Outreach Tools •  Easily creates canvass packets and phone lists to support your outreach Track Consumer Conversations •  Keep track of contact attempts, conversations, and follow ups Maintain and Report On the Data You Collect •  Customizable data entry tools and sophisticated reporting options Manage Volunteers •  Track the status of volunteers as they sign up for and complete shifts

Get Covered Data (GCD)

Earned Media Campaign In Action

Earned Media In Enroll America’s 11 Campaign States

Earned Media Campaign In Action ARTICLE QUANTITY AND FAVORABILITY INCREASED AS MARCH DEADLINE APPROACHED

Source: Enroll America Communications Program

Results From EA Nationwide Survey

News Advertisements Website/online searches Friends and family

Where have you been getting information about the new health insurance options including HealthCare.gov?

Enrolled Uninsured

Results from EA Nationwide Survey

News Advertisements Website/online searches Friends and family

What has been your MAIN source of information about new health insurance options including HealthCare.gov?

Enrolled Uninsured

Results from EA Nationwide Survey

Local TV National/Cable TV Print Radio Online

Enrolled Uninsured

Lessons Learned: Grassroots Organizing & Earned Media

Lessons Learned •  Following up multiple times yielded

the best results, specifically among certain populations.

•  Collecting information using a

“commit card” was an effective and simple way to collect consumers’ information for follow-up.

•  Following up with consumers over

the phone was one of the most important tools Enroll America staff employed. The increase in enrollment was the strongest among consumers Enroll America was able to both call and email.

Source: Enroll America, State of Enrollment: Lessons Learned from Connecting America to Coverage, 2013-2014, https://s3.amazonaws.com/assets.getcoveredamerica.org/20140613_SOEReportPDFlr.pdf

Lessons Learned •  Engaging ethnic and

specialty media and other trusted sources of information and messengers was crucial

•  Educating staff about

the importance of building relationships with reporters and executing an overall communications and messaging strategy was key

Agenda

Partner Engagement – National, State and Local

Engage Local Communities

Fill Resource Gaps

Trusted Messengers

Communications Echo Chamber

Our Partnership Approach

Large-Scale Convening

Policy & Grounded Practical Guidance

National & State Partnerships

Reaching the Uninsured with Partners

National Community College Partnership Youth •  70 Events across 25 States •  500,000 students reached

National Coalition of Latino Organizations Latinos •  60+ Events across 25 cities: Over 15,000 served in person. •  Media, elected officials, and community partners engagement

Reaching Communities of Color through Faith Faith •  1,500 events at churches, mosques, & synagogues •  Coalition represented over 20 million diverse congregants

Reaching The Uninsured With Partners

Hospitals, Health Centers, & Providers Health Systems •  Developed health provider toolkits, trainings, messaging, and

technical assistance to aid in outreach & enrollment.

National Mayors Month of Action Cities •  Established partnership with mayors across the country to co-

host press conferences, outreach & enrollment events, and op-eds.

Reaching Consumers In-Person Pharmacies •  Partnered with CVS retail pharmacies and through 130 events

reached more than 11,000 individuals across the country.

Lessons Learned

•  Meet people where they are at with messengers they trust

•  Build coalitions with local partners & media outlets •  Engage navigators & certified application

counselors (CACs) for in-person assistance that is consumer friendly & culturally-competent.

•  Encourage partners to become CACs, send information to consumers through their communication channels, and join efforts.

Agenda

Key Takeaways

Financial assistance messages were key

Consumers wanted individualized information

Following up multiple times yielded the best results, specifically among certain populations

Partnerships drove success

In person help was crucial

How to Replicate: Work With Us

Support Outreach

& Enrollment

GCD training and

support

Advanced outreach trainings

Topical webinars

Share best and

promising practices

Assist local partnerships

Continue research

and learning

Resources

•  State of Enrollment: Lessons Learned from Connecting America to Coverage, Enroll America, June 2014, http://www.enrollamerica.org/soe_report/

•  Voices from the Newly Enrolled and

Still Uninsured: A Survey about the Affordable Care Act’s First Open Enrollment Period, PerryUndem Research & Communication and Enroll America, July 2014, http://www.enrollamerica.org/resources/public-education/voices-from-the-newly-enrolled-and-still-uninsured/

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