evaluation of the enrollment experience in connecticut: raising up the voices of urban consumers, ...
TRANSCRIPT
Evaluation of the Enrollment Experience in Connecticut
Raising up the Voices of Urban Consumers, Assisters and Navigators
Jeannette Ickovics, PhDAlycia Santilli, MSW
August 21, 2014
AIM: To evaluate Access Health CT enrollment process from the perspective of consumers as well as Assisters and Navigators
GOALS1) Identify factors that facilitated or impeded enrollment and outreach,
particularly among underserved populations
2) Identify how consumer experience and satisfaction vary between in-person, helpline and website
3) Identify consumer demographic characteristics that influence their experience and satisfaction (race, education, age, etc.)
4) Identify factors that facilitate or impede the enrollment efforts of in-person assisters and navigators
METHODOLOGY
SURVEYS
• 164 in-person surveys• Consumers after enrollment
attempt
FOCUS GROUPS & KEY INFORMANT INTERVIEWS
• 121 phone surveys• Uninsured CT residents
6 Assister focus groups in each region
6 Navigator phone interviewsin each region
In-person Assistance Stands Out• Provided critical service for consumers unable to
navigate helpline and website
• Easier to get and use information
• Rated information significantly better
• Versus helpline or website
KEY FINDINGS
AVG RATING OF INFORMATION PROVIDED (0=WORST, 10= BEST)
6.4
7.2
9.5
0
2
4
6
8
10
website (n=42) helpline (n= 17) in person (n=154)
ABILITY TO GET NEEDED INFORMATION
19
35
19
2824
19
24
33
0
52
94
0
10
20
30
40
50
60
70
80
90
100
never sometimes usually always
%
website (n=42) helpline (n= 17) in person (n=154)
KEY FINDINGS
High Rates of Consumer Satisfaction• 95% reported application and enrollment processes
were definitely or somewhat easy
• 90% would definitely recommend AHCT, and an
additional 9% would probably recommend AHCT
• Latinos, blacks and those with less education reported higher satisfaction
DIFFERENCES IN SATISFACTION BY RACE(0=WORST, 10= BEST)
9.39.5 9.6 9.8
8.5
8.99.3 9.4
8.38.6
8.99.3
0
2
4
6
8
10
application process enrollment process AHCT overall in-person information
Latino/a (n=78) Black (n=43) White (n=38)
KEY FINDINGS
Consumers Information Needs• Priority: cost and availability of financial
assistance for insurance premiums
• Most common reason for non-enrollment: need more information
• Translation: 98% of Spanish speakers who needed an interpreter always got one
AHCT NON-ENROLLMENT
Total sample n= 164
Did not enroll n= 40
24 needed additional information
16 will enroll at a later date
6 had technical problems
4 reported that insurance was too expensive
Enrolled
n= 124
AHCT REACH
0 10 20 30 40 50 60 70 80 90 100
radio commercials
Internet
library
newspaper ads
TV commercials
news programs
family/ friends
word of mouth
percent of respondents
Informal Networks: Consumers mostly heard about AHCT through ‘word of mouth’ and ‘family and friends’
KEY FINDINGS: ASSISTERS and NAVIGATORS
Factors that facilitated enrollment
• Resource coordination and support:
o Outreach team
o Helpline
o Brokers
o Assister network
• Technology functioned properly
• Consumers did not have complex needs or family situations
KEY FINDINGS: ASSISTERS and NAVIGATORS
Factors that impeded enrollment
• Poor coordination and teamwork
• Lack of promotional materials and support
• Technology challenges
• Training gaps
RECOMMENDATIONS
1) Raise awareness of AHCT among hard-to-reach populations through systematic, culturally competent, targeted outreach.
2) Maintain a coordinated year-round program of in-person assistance in all regions of the state of sufficient size and strength to meet the needs of underserved populations.
RECOMMENDATIONS
• Outreach
• Management and Coordination
• Training and support
• Year-round operation
RECOMMENDATIONSOutreach
• Target consumers less likely to have heard of the marketplace – Spanish speakers, men, less education
• Adopt grassroots outreach strategy
• Leverage “word of mouth” strategy – Latinos, African Americans, young adults under 35
• Improve/tailor marketing support for events– web, social media, flyers, on-site
RECOMMENDATIONSManagement and coordination
• Improve communication and coordination
– Access Health CT
– Department of Social Services
– Office of the Healthcare Advocate
– Those providing in-person assistance
• Fund and strengthen Navigator function
– To preserve crucial regional coordination and oversight of in-person assistance
RECOMMENDATIONS
Enhance support– Training
– Technology: website, wi-fi access, laptops
– Real-time troubleshooting (helpline and IT support)
– Language translation
RECOMMENDATIONS
Provide year-round operation
• Ongoing outreach and in-person enrollment assistance in underserved communities
• In-person assistance to help consumers use, maintain and renew insurance coverage