using motivational interviewing during health insurance enrollment · 2018. 4. 2. · using...

Using Motivational Interviewing During Health Insurance Enrollment

December 18, 2013

Brittany Beard Program Specialist www.mpca.net

Motivational Interviewing Is Not

Telling someone how or what to do Giving someone the answer Giving yourself more importance than the

client/patient

Motivational Interviewing Is

Develop relationships w/ emphasis on identifying barriers to a decision/action

Determine individualized goals

Motivational Interviewing & The Stages of Change Pre-contemplation ◦ Avoidance, not seeing the situation

Contemplation ◦ Acknowledging the situation, but not ready to

change

Preparation/Determination ◦ Taking steps toward change

Motivational Interviewing & The Stages of Change

Action ◦ All-consuming

behavior change

Maintenance ◦ Behavior change that

is integrated into a person’s life

Motivational Interviewing Skills Empathy Differences between current and desired

behavior Avoid arguing Support client in feeling that they can

change Accept clients’ feelings Be non-judgmental Listen – don’t tell

Four Processes Focusing ◦ Clarify Focus: your agenda ◦ Their Goals

Evoking ◦ Their reasons ◦ Their pace Avoid “righting reflex” through questions

Planning ◦ Reasonable next step: different for everyone ◦ What help do they need

Engaging ◦ The environment ◦ Facial and physical movements

Avoiding the Righting Reflex

Ask for their concerns ◦ Don’t explain yours first

Have them list positives that will come from action ◦ Negatives from not acting

Barriers ◦ Do they outweigh the positives listed? ◦ Easier than dealing with the negatives of not

acting?

Engaging through OARS

Open-ended questions Affirmations

Reflective Statements

Summary

Asking Open-Ended Questions

Helps in avoiding telling someone what to do

Allows client to come to their own

conclusions Client feels ownership if they come up

with the solution themselves

Using Affirmations

Encouragement gives environment conducive to change

Positive statements about their

knowledge of the ‘issue’ Reassurance of positive influence and

actions for family’s welfare

Reflective Statements

Use words directly used by the client, reinforce the thoughts and actions they developed for themselves

Repeat: ◦ Why they haven’t sought insurance previously ◦ Why they need to do something ◦ Statement about importance of action

Summary

Key, emotional messages from the client Confirm through open ended questions ◦ Did you summarize their feelings/conclusions ◦ Have them restate their next steps “What do you want to happen next?”

◦ Have them discuss their timeline “What should you be doing to make that happen in

the next few days or weeks?”

What does this look like for O&E?

Engage ◦ Additional Question

on next page ◦ Reflect, summarize

using direct quotes

Planning ◦ “What would be a

reasonable next step to you?”

◦ “What do you need help with to enroll in a plan before Open Enrollment ends (3/31)?”

Focusing ◦ “I thought today we

could explore some options available to you and your family for affordable healthcare insurance.”

Evoke ◦ “Do you ever worry

about your current situation?”

◦ “What is stopping you from enrolling?”

Additional Phrases to Use to Engaging a Client’s Thoughts and Self Identified Next Steps

“What do you know about the new health plan benefits?” “How are you currently accessing healthcare and how are

you handling the bills?” ◦ “What sort if stressors does that prompt for you and your family”

“It sounds like…” “What I’m hearing you say is…” “You’ve expressed that you’re feeling like…” “You know your situation best, what do you see as your

biggest barrier?” “You seem very interested in taking care of your family

and yourself, what do you need to do to continue to do that?”

Your experiences and Challenges

Discussion of experiences already this would have helped in

Related experiences you’ve faced

Key Take Away Conversation should revolve around open

ended questions to the client

Client identifying their own behaviors

Client developing their own solutions, timelines, and challenges they will face

Client created next steps and timelines

Follow up is offered and completed

Questions?

Brittany Beard ◦ Program Specialist ◦ 517.827.4077 ◦ bbeard@mpca.net

Phillip Bergquist ◦ Director of Health Center

Operations & CHIPRA Program Director

◦ 517.827.4073 ◦ pbergquist@mpca.net

Natasha Robinson, MS ◦ Program Specialist ◦ 517.827.0476 ◦ nrobinson@mpca.net

Julie Tatko, MSW ◦ Program Coordinator ◦ 517.827.0882 ◦ jtatko@mpca.net

For additional questions please contact the following: