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’

AWARENESS OF AHCT UNINSURED RESPONDENTS

25%

40%

35%

applied did not apply never heard of AHCT

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

FUNDERS