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BEST PRACTICES FOR OUTREACHING AND MANAGING NEW ENROLLEES FOR HEALTHCARE COVERAGE Presented By: TCA Health, Inc
National Center for Health in Public Housing • The National Center for Health in Public Housing (NCHPH), a
project of North American Management, is supported in part by grant number U30CS09734 from the Health Resources and Services Administration. NCHPH provides training and technical assistance to strengthen the capacity of federally-funded health centers to increase access to health care, eliminate health disparities, and enhance health care delivery for the millions of residents of public and assisted housing.
• The mission of the National Center for Health in Public Housing (NCHPH) is to strengthen the capacity of federally funded Public Housing Primary Care (PHPC) health centers and other health center grantees by providing training and a range of technical assistance.
Percentage of Uninsured Patients Comparison
32% of Look-Alikes
32% of Grantees
16% General Population
Source: Health Resources and Services Administration. 2012 Data Snapshot. Bureau of Primary Health Care.
2011 Public Housing Primary Care Data
33% Uninsured
In 2011, 62,140 patients seen by PHPC grantees were uninsured.
That is 33% of the patient population.
Source: Health Resources and Services Administration. 2011 National Public Housing Data. Bureau of Primary Health Care.
Who are the Uninsured? • Age: The uninsured are disproportionately between
the ages of 18 and 34.
• Race/Ethnicity: Uninsured rates for Hispanics (30.7%), Asians (18.1%) and Blacks (20.8%) are higher than for non-Hispanic whites (11.7%).
• Employment: Among full-time workers 15.0% were uninsured. Over a quarter (28.5%) of part-time workers were uninsured, the same percentage as among those who were unemployed.
• Income: Individuals with lower incomes are more likely to be uninsured, although 37% of all uninsured Americans have household incomes above $50,000.
Source: Assistant Secretary for Planning and Evaluation. (2011) "Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey.“U.S. Department of Health and Human Services. Web. 25 Mar. 2014.
Resources
• Key Facts about the Uninsured Population
• Best Practices in Outreach and Enrollment for Health Centers
• Outreach and Enrollment
• HRSA’s Health Center Outreach and Enrollment Assistance
WEBINAR PRESENTED BY
Dr. Laverne Barnes, Medical Director Veronica Clarke, President and CEO
Mariann Chisum-McGill, Director of Programs Darryl Rogers, Public Housing Outreach Assistant
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BEST PRACTICES FOR OUTREACHING AND
MANAGING NEW ENROLLEES FOR HEALTHCARE
COVERAGE
TCA Health, Inc., NFP Your Health Care Provider Since 1970
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WEBINAR PRESENTED BY
Dr. Laverne Barnes, Medical Director Veronica Clarke, President and CEO
Mariann Chisum-McGill, Director of Programs Darryl Rogers, Public Housing Outreach Assistant
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Established in 1970 as a privately owned clinic
In 1991, TCA Health began to receive federal funding and converted to a FQHC.
Currently the only FQHC in Chicago that is located in the Public Housing Development.
The clinic was developed to serve the public housing residents with their health needs.
TCA Health is one of the first 7 FQHC’s to receive PHPC funding.
Provide primary and preventive healthcare including ancillary services such as WIC and
Welfare to Work, Support for Pregnant women, Child Birthing and Parenting classes,
Breastfeeding Counseling Services, Immunizations, Nutritional Counseling, Mental Health
Services, Licensed Clinical Social Worker, In-House Dietitian. Case Management, Health
Education and Enabling Services
In addition, we provide wellness services including Youth Sports Fitness Program, Adult
Fitness Program, Cooking Matters Classes, Community Gardening Projects, Food
Accessibility Initiative, Community Health Education Workshops and Access to Mobile Health
Care
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TCA Health, Inc. is located at entrance to CHA’s Altgeld Gardens/Murray
Homes (Altgeld) in the Riverdale community of Chicago on the City’s far
south side bordering Indiana.
Community is isolated with very limited commercial and shopping areas or
public transportation.
The area includes large tracts of land -- a sewage treatment plant and a large
forest preserve/open lands;
The residential portion is dominated by Altgeld (1,200+ public housing families)
which is surrounded by other low income housing.
The community is 96% African American, young (62% of Altgeld residents are
under age 25) and poor. (78% of the Riverdale population lives below 200%
of poverty and 56% live below 100% of the poverty level).
Health disparities affecting the community include high rates of mortality,
childhood obesity, asthma, diabetes, and cardiovascular disease. The
community is regarded as a food desert.
The community is not without resources—there are six public and charter
schools, branches of the Chicago Park District and Public Library, and TCA
Health, Inc. as a full service Federally Qualified Health Center.
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LEARNING OBJECTIVES
Gain an understanding of best practices for outreach
and managing new enrollee for health care
coverage
Learn about creative outreach strategies to implement
within hard to reach communities
Share ideas that can strengthen the messaging about
enrolling in healthcare coverage for the uninsured
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GUIDING PRINCIPLES
Educate Clinic Team - Created informative working groups and systems within the clinic to ensure that staff were knowledgeable about the uninsured population. Also that resources and a link to the health coverage was made available immediately for patients that were in need.
Collaborated with Community Partners- We began to serve as advocates and messengers for getting the uninsured health coverage by educating those that came into contact with our clinic patients, public housing residents and the uninsured on a day to day.
Good Neighbor Approach– Maximize opportunities through partnerships by utilizing the good neighbor system. To reach the unreachable, we partnered with local businesses that community residents and our patients visited day to day such as the Laundromat, grocery store, library, barbershop, property management office, waiting rooms, liquor store etc. and provided education and enrollment
Identified Ambassadors- Sought opportunities to identify individuals who became students of learning and that served as great representatives to speak to others in our behalf on the getting coverage for healthcare. Some of our ambassadors are outreach staff who are now Certified Application Counselor or the barber who had no health cover for 7 years.
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1. Public housing resident engage with clinic for medical
emergencies
2. Staff lack knowledge about ACA
3. Limited staff to support with the education and
enrollment for the uninsured
4. Community residents not educated on the ACA so
many not encouraged to enroll
5. Not able to reach residents where they live
6. Residents were not receptive to changes in Medicaid
expansion nor were they “trusting the system”
7. Newly insured failed to use their benefits
effectively
• Socialize public housing residents who may not have
had health care for a really long time and shared the
benefits of having coverage
• Educated the medical providers, nurses, MA and
patient services on the Medicaid expansion and ACA.
• Built and trained a stronger outreach team so that they
could support in our efforts
• Revised the Selection and Hiring Process to ensure
outreach staff was a good fit for the clinic and
communities we serve
• Offered the opportunity to sign up the uninsured in
coverage during appointment and educate about
preventive care
• Re-assess the uninsured patient with Pink Card, Self
Pay and sliding scale prior to appointment
• Partnered with the housing authority and other FQHC
to educate public housing residents about healthcare
coverage on a larger scale or a large venues
• Provide the clinic with a response to those patients
facing financial challenges who wanted healthcare
coverage but was not able to afford
Challenges Opportunities
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PATIENT SATISFACTION COMMITTEE Vision and or mission
TCA Health Patient Satisfaction Committee provides guidance on how to improve the patient and family experience at the clinic.
Purpose
To be the voice for the patients and to ensure that the consumer’s point of view, perspective, and experience are not only heard, but also integrated into the service and quality improvements that are engineered to ensure high-quality, customer-centered care. Through their unique perspectives, they give input on issues that impact care, ensuring that the next patient or family member’s journey is easier.
Committees Responsibility:
• Increased understanding of the new healthcare coverage system's in support of patients, families, public housing community and staff.
• Promote respectful, effective partnerships between patients, families, staff and community.
• Strengthen community relations to support residents understanding the Affordable Care Act.
• Showcase and display any new healthcare improvements or changes that have been made to support the needs in the community .
• Serve as advocates, ambassadors, supporters, and educators for patients, families and the communities we serve.
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EIP- ENCOUNTER IMPROVEMENT TEAM
Taking the fear of asking to be seen for
appointments
Focused on local insurance efforts
Focused on external clients/patients via
outreach activities
Promoting a commitment to serving patients
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WE SAY YES CAMPAIGN
• Saying Yes to current, potential, and existing
patient with conditions of understanding
• Being a vested partner in our patients health
• Providing every opportunity for a patient to get
healthcare coverage
• Reaching the unreachable that need health
care coverage
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REDEFINING OUTREACH’S EFFORTS TO
SUPPORT THE UNINSURED AND NEWLY
INSURED
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EMPLOYEE TRAINING
• Conducted an all staff meeting and provided training on the Affordable Care
Act and how it will impact on clinic patients, specifically the public housing
population
• Offered small group presentation at the weekly team huddles in the clinic
• Held small weekly information sessions in the clinic that included both clinic
patients and employees (so they could each hear the others concerns and
learn from one another)
• Cross-trained all patient service representatives as Countycare Assisters –
benefit is that they are knowledgeable about health coverage opportunities
• Shared ACA information and success stories through quarterly newsletter,
community portal, all staff meetings and during clinic team huddles
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Selection Process • Solicit recommendations from the community
• Sought someone who was a champions for coverage
• Sought someone that is respected by community residents and leaders
• Personality that is a good fit for community relation building
• Someone flexible in scheduling
• Able to engage all ages
• Has a proven successful track record within the community
• Utilize the involvement of other outreach staff to participate in the
selection process
• Offered peer to peer training for the newly hired to support transfer of
information about the ACA
HIRE THE RIGHT OUTREACH STAFF
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REVAMPING THE OUTREACH TEAM
• Enhances the outreach team with funding from HRSA
• All Certified Application Counselors
• All trained Cook County Assisters
• All have been train to conduct educational workshops for individuals and
large groups
• All are able to do more than enrollment, example one serves as the mobile
health van driver 2 days out of the week
• All have proficient knowledge about clinic health services
• All can schedule appointments for a doctors appointments
• All have the ability to waiver fees for the eligible insured patient needing to
see a provider for the 1st time
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REDEFINING OUTREACH’S STRATEGY
SMALL VENUES Local Advisory Council Meetings
Neighborhood Grocery Stores
All initiatives held on site at clinic
Property Management Office – Rent Week
Barbershop
Liquor Store on Saturdays
Library
High School Lunch Room
Parent Groups
Through various partnership created
through the clinics health and wellness
initiative
All places that more than 1 will gather at a
given time
LARGE VENUES
Health fair
Event hosted by the Housing Authority
City Colleges
Neighborhood Health Club-Blast, Planet
Fitness
Job Fairs
Flea Market
Walkathons
Community Service Fairs
Community partners events
Churches
School event
Employer events
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NEW OUTREACH STRATEGIES
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Example of Marketing Materials for the Newly
Insured
March 2013 Dear New Member: We at TCA Health, Inc. wish to take a moment to welcome you to our medical practice under the new County Care Insurance Plan! We want you to know that we appreciate the opportunity to take care of you. Thank you for selecting us as your patient centered medical home and we look forward to serving you. Our goal is to provide you with the best coordinated and highest quality medical care by taking a personalized approach to understanding your healthcare needs and treatment. Your health is our primary concern. Our philosophy is to provide comprehensive care while treating every patient with dignity and respect. We treat a full spectrum of both acute illnesses and chronic conditions and offer a wide variety of services and preventive programs to address your physical, mental, and spiritual well-being. “We Strive to Empower Wellness.”
To expedite the new patient registration process, when you arrive for your first appointment we will ask that you complete and bring the following forms: (see enclosed forms)
PATIENT REGISTRATION
ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES
On your first visit we ask that you also bring with you the following documentation:
COUNTYCARE INSURANCE CARD
CURRENT MEDICATIONS
PHOTO IDENTIFICATION (Driver’s license/State I.D.)
Again, thank you for choosing us. We look forward to seeing you at the clinic and will do our best to make your visit is as pleasant, efficient and complete as possible. If you have not already done so, please call 773 995-6300 and schedule an appointment for a checkup or doctor visit. Please remember to ask the front desk staff for your New Member Welcome Packet when you arrive. We look forward to caring for all of your medical needs. Sincerely, Patient Services Supervisor
TCA Health, Inc.
1029 E. 130th Street
Chicago, IL 60628
773-995-6300
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WAYS WE SERVICE THE NEWLY INSURED
• Newly insured are provided with information about how to utilize their health
benefits
• Patient Services staff are train to assist the newly covered patient with how to
utilize benefits
• On a monthly basis, we review the County Portal and the Provider Portal to
check the status for new Medicaid expansion enrollee members and send a
welcome letter
• New eligible Medicaid expansion enrollee are offered appointments for health
services- many have been without healthcare for years
• Newly Covered did not understand that purpose of preventive screenings, so
we promoted those that had not seen a doctor in the last 12 months to get an
annual exam.
• Lobby education on the benefits of coverage conducted in the waiting room
• Outreach secures the daily appointment roster and dialogue with all self pay,
sliding scale and uninsured for education and insurance
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SUCCESS STORIES
• As an independent barber, Andre went 8 years without having insurance. However, after he attended a
TCA Health Enrollment Fair hosted at Silk and Classy Barbershop in Dolton, IL. Andre was able to get
insurance. He participated in a educational workshop held at the barber shop and met with a certified
application counselors and learn more about new healthcare benefits offered through the Affordable Care
Act. On the day of sign up Andre was informed that he was eligible for Medicaid expansion and was
referred to CountyCare. He signed up while at the barbershop that same day. He also was given an
appointment at TCA Health where he was offered a variety of medical support. Andre is now a champion
for healthcare coverage for the uninsured and serves as a testimony for other barbers. TCA continues to
host enrollment fairs at the barbershop and at barber colleges near the public housing community. Now
Covered
• 23 year old male away at college became ill called mother for medical insurance information. Informed
coverage stopped at age 19. Sought health services at an emergency room for all health challenges or
either self medicate over the counter. Now covered (pre-existing health problems)
• 31 year old male employed part-time but has been uninsured since the age of 19. Has utilized the
emergency room as the source of care. Now covered
• 61 year old female diagnosed with cancer and receiving treatment under a special grant but funding is
depleted- Now covered
• Family of 4 – Male head of household unemployed benefits ran out. All 4 family members Now covered
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CLOSING REMARKS-TAKE AWAYS FOR BEST
PRACTICE • The outreach staff play an important role in educating the uninsured about
health services and benefits
• It takes the entire medical team family to act as advocates to ensure that
patient understand their benefits and how to navigate through the systems
• Peoples lives are being changes because we have made a change to how we
conduct business at the clinic
• Its important to spend time talking with people about preventive care when
they are being enroll- it part of educating them on self care
• Utilizing other team members to be on hand to talk to the newly enrolled
(such as the health educator) services as a great benefit to the newly insured
especially since many have not seen a doctor for a very long time or have
any understanding of prevent health measures
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QUESTIONS AND ANSWERS
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Q&A
• If you would like to ask the presenter a question please submit it through the questions box on your control panel
• If you are dialed in through your telephone and would like to verbally ask the presenter a question, use the “raise hand” icon on your control panel and your line will be unmuted.
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