Best Practices

General Outreach and Enrollment Assistance

Article Title Author Synopses
ACA Outreach & Enrollment: Southern California Regional Brief Harder+Company Community Research Illustrated fun-facts about what various organizations are doing to increase enrollment rates through outreach and enrollment.
Association for Community Affiliated Plans: Guide to Enrollment Assisters Association for Community Affiliated Plans The Association for Community Affiliated Plans compiled a guide that provides descriptions of various enrollment assisters. These descriptions include training and other related requirements from different entities.
Consumer Assistance in Health Reform The Henry J. Kaiser Family Foundation Article illuminates on the lack of understanding by many consumers of the ACA and its impact on them, while providing key tools that can be utilized by consumer assisters.
Covered California Overview (PPT) Chris Kelly, Covered CA Presentation outlines the mission of Covered CA and strategies for outreach and community mobilization.
Encouraging Outreach Practices for Public Health Insurance
Summary of articles by:
Xochitl Castañeda, MA, California-Mexico Health Initiative;
Zoe Cardoza Clayson, ScD, San Francisco State University;
Tom Rundall, PhD, University of California, Berkeley;
Liane Dong, DrPH, University of California, Berkeley;
Margo Sercaz, University of California, Berkeley;
and
Michael R. Cousineau, DrPH, University of Southern California;
Gregory D. Stevens, PhD, University of Southern California;
Albert Farias, MPH, University of Southern California.
Summary by:
Norma Dominguez, MPH, CalOptima
Short summary of two prominent articles that focus on public health insurance outreach. The original articles focus on children’s public health insurance, but many of the lessons learned can be applied to Medi-Cal outreach. With the Medi-Cal expansion that has occurred as a result of the ACA, the outreach strategies included could provide key starting points in planning and implementing outreach initiatives in communities where Medi-Cal eligible individuals reside.
Enroll America’s Grassroots Campaign and Early Lessons Learned, November 2013 – February 2014 Molly Warren, Enroll America Article provides statistics on the health insurance enrollment success and outlines some challenges that still exist.
Health Coverage Eligibility Worksheet The California Endowment Worksheet that allows individuals to determine their eligibility with tables and vital definitions to terms used by enrollment assisters.
Health Reform Implementation: Opportunities for Place-Based Initiatives
Gerry Fairbrother, PhD, The Center for the Study of Social Policy
Tara Trudnak, PhD, The Center for the Study of Social Policy
Brief that describes impacts of the ACA, special concerns, maximization of enrollment, and the promise of health care reform.
In Their Own Words: Consumers’ and Enrollment Counselors’ Experiences with Covered California PerryUndem Research/Communication Article documents the experiences of various consumers and CECs during the enrollment process. There was significant confusion regarding the ACA and one of the biggest challenges for CECs was enrolling individuals who were eligible for Medi-Cal.
ITUP Outreach and Enrollment Notes
Kiwon Yoo, Insure The Uninsured Project
Notes from the 18th Annual Insure the Uninsured Project held in February 2014. These notes contain various successful strategies that were used by the different panelists that were present.
Marketplace Enrollment Helpers
Alliance for Health Reform
Publication from the Robert Wood Johnson Foundation that summarizes the funding for enrollment helpers as well as general information about various resources on defining their role and possible funding.
Navigator and In-Person Assistance Programs: A Snapshot of State Programs
The Henry J. Kaiser Family Foundation
Provides details about navigator and IPA functions, as well as their differing roles that often vary by state.
Preparing for the Affordable Care Act: An Examination of Coverage Expansions in L.A. County: OERU
Neelam Gupta, L.A. Health Action
Veronika Kiselev, L.A. Health Action
John Connolly, L.A. Health Action
Article supplies information regarding coverage expansion and strategies for Outreach, Enrollment, Retention, and Utilization.

 

Community Health Centers

Article Title Author Synopses
Best Practices in Outreach and Enrollment for Health Centers
Jessica Kendall, Enroll America
Jennifer Sullivan, Enroll America
Enroll America article that identifies 5 main categories of best practices: outreach staff, adequate technology, assignment of roles, retention/renewal of patient insurance status, and obtaining resources.
Ready, Set, Enroll: Community Health Center Strategies to Facilitate Enrollment of Uninsured Patients into Coverage Under ACA Rafael A. Gomez, MPP, Pacific Health Consulting Group Bobbie Wunsch, MBA, Pacific Health Consulting Group Leonard Finocchio, DrPH Publication focuses on the strategies used by community health centers to assist their patients with insurance coverage, both Medi-Cal and subsidized insurance programs. Topics include: culture of coverage, patient awareness, and enrollment assistance.

 

Young Adult Population

Article Title Author Synopses
Covering Young Adults Under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion
Sara R. Collins, The Commonwealth Fund
Petra W. Rasmussen, The Commonwealth Fund
Tracy Garber, The Commonwealth Fund
Michelle M. Doty, The Commonwealth Fund
Article outlines the importance of educating young adults in the ACA and its effect on them. Many are unaware of their eligibility and others will be negatively affected by states that are not expanding their Medicaid program. Most often affordability was the main reason for many young adults choosing to forego health insurance coverage, not invincibility.
CSU Project Aims to Boost Young Adult Exchange Enrollment California Healthline Article from California Health Line that details young adult enrollment rates and further information on the CSU program to increase enrollment rates.
CSU Using Grant To Tell Students About State Insurance Exchange California Healthline Brief article from California Health Line regarding young adults, specifically college students, and a grant that was issued to educate them about the state health insurance exchange.
Enrolling Young Adult Demographic Podcast (Interview Transcript) Megan Hiltner, National Family Planning Short transcript of an interview with Christina Postolowski, Senior Policy Analyst at Young Invincibles, who is actively involved in the “Get Covered” national campaign.
Enrolling Young Adults: Outreach and Education Strategies from the Field (PPT) Aaron Smith, Young Invincibles PowerPoint Presentation that provides interesting statistics about the uninsured young adults. Emphasis on storytelling and detailed facts to appeal to the young adult population.
Helping Students Understand Health Care Reform and Enroll in Health Insurance Christina Postolowski, Young Invincibles
Abigail Newcomer, Center for Law and Social Policy
Guide includes information regarding student health options, applications, assistance with enrollment, and outreach methods that would excel in a community college environment.

 

Latino Population

Article Title Author Synopses
Helping Individuals Obtain Health Coverage Under the Affordable Care Act: Outreach and Enrollment Strategies for California Hospitals Kaufman, Hall, & Associates This article focuses on improving access to health coverage in California. It includes tools for enrollment, the role hospitals can play, and strategies that hospitals may employ when assisting with outreach in the community where a significant portion of the uninsured live.
Latinos and Health Care National Latino Behavioral Health Association Fact Sheet that shows 1 in 3 uninsured people are Latino and lays out the benefits of enrolling both in subsidized health insurance and Medicaid. Also includes information about Ventanillas de Bienestar webinars.
Outreach and Enrollment Strategies for Latinos Under the ACA (PPT)
Rodolfo Vega, John Snow, Inc.
Clancey Bateman, John Snow, Inc.
Jim Maxwell, John Snow, Inc.
Manuela McDonough, National Council of La Raza
PowerPoint Presentation on how current outreach and enrollment efforts might not be the best approach for the Latino population; emphasizes that community-based organizations might provide more culturally appropriate information.
State Gearing Up for Public Education Campaign Targeting Latinos Angela Hart, California Healthline California Healthline article discussing trust issues within the Latino population and the need for grassroots approach to outreach, including tupperware parties.
Strategies for Behavioral Health Organizations to Promote New Health Insurance Opportunities: In Latino and Hispanic Communities Substance Abuse and Mental Health Services and Administration Brief article that lists 10 strategies that organizations can use to introduce health insurance options to the Latino community; examples are included.
The Affordable Care Act and Latinos National Latino Behavioral Health Association Fact Sheet that includes frequently asked questions (FAQs) about the ACA and the Latino population.
The Crucial Role of Community Based Education, Outreach, and Enrollment Under ACA (PPT) Suzie Shupe, California Coverage & Health Initiatives PowerPoint Presentation on the value of community-based OERU practices as they respond to local needs in the appropriate language. Describes key findings from literature reviews, interviews, and general comments from providers and organizations.
The Whys, Whats, and Hows of Convincing Specific Populations to Enroll in Exchanges Anthony Wilson, California Healthline California Healthline article on methods of reaching the Latino community and motivating them to enroll in health insurance. Ideas include: PSA announcements by prominent members of the Latino community and use of community health workers (promotores/as).

 

Child Population

Article Title Author Synopses
All Children Have Coverage
Joel Diringer, JD, MPH, Diringer and Associates
Dana Hughes, DrPH, University of California, San Francisco
Michael Cousineau, DrPH, University of Southern California
Resource guide that describes strategies to ensure that all children are covered through creation of “gap” programs for ineligible children, focusing on retention, and being aware of policy efforts.
Increasing Enrollment and Retention in Children’s Health Insurance Statewide Programs Through Trained Assistors
Stephanie Ha, National Health Foundation
Marlene Larson, National Health Foundation
Julia Pennbridge, National HealthFoundation
Article shows evidence that families that were assisted with enrollment were more successful in retention and that trainers must be continuously trained in order to improve effectiveness.
Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act The Henry J. Kaiser Family Foundation Article that summarizes lessons learned from the Medicaid/CHIP program. Includes various graphs and sources from which families gain their health care knowledge, broad vs. targeted messages, and simplification of the application process.
Outreach, Enrollment, Retention, and Utilization Strategies for Health Care Coverage
Michelle Wood, MPP, Community Health Councils
Caroline Rivas, MSW, Community Health Councils
Lark Galloway-Gilliam, MPA, Community Health Councils
Compilation of strategies determined to be most successful by 10 children’s health initiative programs.
Three Steps to Provide On-Site Enrollment Assistance at your School/Early Learning Program/After-School Program ALL IN, The Children’s Partnership Fact Sheet that provides strategies for conducting enrollment events on school campuses.
Use of Outreach and Enrollment Strategies in California
Michael R. Cousineau, DrPH, University of Southern California
Gregory D. Stevens, PhD, University of Southern California
Albert Farias, MPH, University of Southern California
Paper includes a table that lists studied outreach & enrollment strategies and concludes that current outreach efforts are going well despite the unstable funding and lack of knowledge of best practices with certain populations.

 

Foster Youth Population

Article Title Author Synopses
Covered Til 26: Fact Sheet Children Now Short fact sheet that states the impact of the ACA on foster youth, particulary those older than 21. Former foster youth are eligible for coverage until 26 and this fact sheet contains contacts and numbers to call for further information.
Foster Care Children and the Affordable Care Act
Brooke Lehmann, Georgetown University Center for Children and Families
Jocelyn Guyer, Georgetown University Center for Children and Families
Nicole Tambouret, Georgetown University Center for Children and Families
Short article that provides key ACA provisions and the crucial role that will be played by outreach advocates.
Medicaid to 26 for Youth in Foster Care: Key Steps for Advocates
ChildFocus, Inc. Article that provides key steps for advocates to take when reaching out to both current (about to age out) and former foster youth. Also provides a list of questions to ask agencies that could offer assistance.
Medi-Cal Coverage for California Former Foster Youth Under the Affordable Care Act Alliance for Children’s Rights Informative flyer that includes frequently asked questions by former foster youth. Included are questions regarding moving out of state and a main contact person for former foster youth in LA county.
Medi-Cal Coverage for Former Foster Youth (PPT)
Ted Lempert, Children Now
Kelly Hardy, Children Now
Alice Bussiere, Youth Law Center
Jessica Haspel, Children Now
Todd Johnson, Department of Health Care Services
Presentation on how to enroll former foster youth with a discussion on overcoming barriers; examples of best practices for outreach are explored.
The ACA’s Provision of Medicaid for Foster Youth (PPT) Tricia Brooks, Georgetown University Health Policy Institute Webinar presentation on the ACA’s impact on foster youth. Contains data on health needs, current policies, and outreach suggestions.
The ACA’s Provision of Medicaid for Foster Youth (Webinar Video) Tricia Brooks, Georgetown University Health Policy Institute Video recording that accompanies the PPT slides.

 

Veteran Population

Article Title Author Synopses
Children of Veterans and Health Coverage (PPT) Sidney L. Gardner, MPA, Children and Family Futures This presentation provides an overview of statistics for children of veterans; there is an emphasis on how the VA cannot meet the needs of veterans’ families with their current resources and the consquences of inaction. A data snapshot for Orange County veterans is included as well as outreach implementation plan tasks.
Impact of Expanding Medicaid on Uninsured Veterans: Summary Jennifer Haley, Urban Institute’s Health Policy Center

Genevieve M. Kenney, Urban Institute’s Health Policy Center
This summary article presents one of the main issues encountered by veterans and their families when enrolling in health coverage: affordability. Although, the ACA provides subsidies for private health plans, and some families may qualify for Medicaid, there are veteran families that might not qualify for Medi-Cal but be unable to afford private health insurance, even with subsidies.
The Affordable Care Act and Veterans’ Family Members U.S. Department of Veterans Affairs Fact sheet that provides some health insurance options for families of veterans who do not currently receive health insurance through their employer, TRICARE, or other VA programs.
Uninsured Veterans and Family Members: State and National Estimates of Expanded Medicaid Eligibility Under the ACA Jennifer Haley, Urban Institute’s Health Policy Center

Genevieve M. Kenney, Urban Institute’s Health Policy Center
Article breaks down the estimates regarding uninsured veterans and eligibility for health coverage through Medicaid or Employer-Sponsored Health Insurance.
Uninsured Veterans and Family Members: Who Are They and Where Do They Live?
Jennifer Haley, Urban Institute’s Health Policy Center
Genevieve M. Kenney, Urban Institute’s Health Policy Center
Policy brief that examines the number of uninsured veterans and their families and assesses how many of them would gain Medicaid coverage as a result of the ACA.
Veterans Administration Health Care and the Affordable Care Act U.S. Department of Veterans Affairs Fact sheet that outlines some of the benefits of receiving care through the Veterans Administration.
Veterans Administration Health Care and the Affordable Care Act: Frequently Asked Questions U.S. Department of Veterans Affairs Document provides answers to questions that may arise regarding the ACA and health care provided by the Veterans Administration.

 

Formerly Incarcerated Population

Article Title Author Synopses
County Jails and the Affordable Care Act: Enrolling Eligible Individuals in Health Coverage Anita Cardwell, National Association of Counties
Maeghan Gilmore, National Association of Counties
Outlines the effect of the ACA on county jails, enrollment procedures, issues related to enrolling inmates, and steps that can be taken when preparing to enroll formerly incarcerated individuals.
Medicaid Access for the Formerly Incarcerated Under the ACA: Helping the Oft-Forgotten Lois M. Davis, RAND Corporation Article describes some of the health issues that are faced by the formerly incarcerated and the challenges that will arise when enrolling them in the Medicaid program. Recommendations that best address some of the challenges are provided.
Medicaid and Financing Health Care for Individuals Involved with the Criminal Justice System Legal Action Center Policy brief that emphasizes the lack in continuity of care for formerly incarcerated individuals. Furthermore, it provides a glimpse into the impact that Medicaid expansion will have on this population.

 

Useful Links

http://www.cpca.org/index.cfm/policy-advocacy/policy/outreach-and-enrollment-resources/
http://www.allinforhealth.org/toolkit
http://www.acalibrary.org/home/philanthropy-reports
http://www.urbanstrategies.us/am_portfolios/ventanillas-de-bienestar-windows-of-well-being
http://www.calyouthconn.org/outreach-community-education
http://www.ylc.org/our-work/action-litigation/aging-outtransition/medi-cal-for-former-foster-youth/