Get America Covered: Planning for Open

Enrollment 3

November 4, 2015

What We’ll Cover

• Thank You!• HRSA Strategy for Open Enrollment

3• Key Dates and Messages• Successful Practices & Lessons

Learned• Grantee Experiences

– North Carolina Community Health Center Association

– Mountain Laurel Medical Center • How You Can Help• Resources

Thank You!

• HRSA grantees and stakeholders played a major role in ensuring the successful implementation of the Affordable Care Act during the first two Open Enrollment Periods.

• To date, 17.6 million Americans have gained coverage and the uninsured rate is at its lowest level ever.

HRSA Strategy for Open Enrollment 3

• Provide resources and support that will help grantees have the greatest impact and help meet three goals:– Facilitate the enrollment process among

new and re-enrolling individuals eligible for coverage through the Health Insurance Marketplace

– Improve health insurance literacy– Promote the benefits of preventive

services

Key Dates for Open Enrollment 3

• November 1, 2015: Open Enrollment for 2016 Marketplace coverage begins.

• December 15, 2015: Deadline to enroll for coverage starting January 1, 2016.

• January 15, 2016: Deadline to enroll for coverage starting February 1, 2016.

• January 31, 2016: Last day of Open Enrollment for 2016 Marketplace coverage.

Key Messages for Open Enrollment 3

• It’s time to get covered. This year’s Open Enrollment runs from November 1, 2015 through January 31, 2016. Don’t miss your chance to get covered.

• Sign up by December 15 and start the New Year with coverage. If you want coverage to start January 1, the deadline to enroll is December 15.

• Financial help is available. Over 8 out of 10 people who enrolled in health coverage through HealthCare.gov qualified for financial help. If you choose not to buy health insurance this year, you may need to pay a tax penalty of $695 or more.

Key Messages for Open Enrollment 3

• Getting covered is easier than ever. Every year, the process of signing-up for coverage gets simpler. You can even apply on your cell phone.

• Free help is available. Get answers to your questions by contacting our trained professionals for free and confidential assistance. Call 1-800-318-2596 or find free in-person help in your community by visiting LocalHelp.HealthCare.gov.

Successful Practices of HRSA Grantees during the

First Two Open Enrollment Periods

Successful Outreach and Enrollment Practices

• Build partnerships.

• Work with the media to get information out about assistance events.

• Play enrollment-focused videos in waiting rooms.

• Provide a group enrollment option for consumers who require less assistance to enroll.

• Provide classroom-style assistance, with assisters floating among consumers to respond to questions.

Successful Outreach and Enrollment Practices

• Highlight successes and events on social media platforms (e.g., YouTube, Instagram, Facebook, and Twitter).

• Mail postcards or personalized letters to provide education and information about upcoming events.

• Encourage consumers to refer friends and family by using word-of-mouth.

• Appoint a project manager to handle open enrollment.

• Make Certified Application Counselors (CACs) as accessible as possible.

Outreach & Enrollment: Lessons Learned from North

Carolina (NC)

NC Community Health Center Association

NC Community Health Center Association & NC Community

Health CentersNCCHCA

• Membership association of community and migrant health centers.

• NCCHCA’s mission is “to promote and support patient-governed community health care organizations and the populations they serve.”

NC’s CHCs• 38 community health centers in

NC

• 32 health centers receive Outreach & Enrollment funding from HRSA. Staff are trained as Certified Application Counselors.

Outreach & Enrollment Landscape in NC

560,357 North Carolinians selected a plan during 2015 Open Enrollment

92% received financial assistance through premium tax credits

• NC uses the Federally Facilitated Marketplace

• No Medicaid expansion • No state “lead” for Outreach &

Enrollment Activities • In addition to FQHCs, 4

organizations across the state funded as Navigators offer in-person assistance

• Active Enroll America presence in NC

Spectrum of Engagement

Outreach: Building Consumer Awareness & Connecting Them to Assistance Partnerships Are Key

Outreach: Building Consumer Awareness & Connecting Them to

Assistance

•Partnerships will look different in each community.

•Activities that happen within partnerships are varied.

•For example: • Offering on-site enrollment assistance at

partner agency. • Establishing referral systems to connect

consumers to assistance.

FQHC Outreach Examples from North Carolina

In-reach: Helping Patients Understand Options

• Map out all points consumers interact with health center

• Train all staff on basic concepts

• Talk to patients again & again– the more contacts, the more likely people are to enroll

FQHC In-reach Examples from North Carolina

Application & Eligibility

Goals of O&E Programs During Application and Enrollment Process• Help consumers complete

application, get eligibility notice, understand why they got results they did, and understand next steps.

• Help consumers understand what to do if their situation changes.

• Help consumers understand basic information about health insurance, understand their options, and feel confident in ability to pick a plan that works for them.

• Help consumers understand and make a plan for keeping coverage and accessing care.

Specific Techniques Assisters Use• Emphasis on up-front education

about application process, potential results, PTC, and health insurance.

• Asking directive questions to assess needs and priorities.

• Checking for understanding using teach back or other methods.

• Rely on partners for questions assisters can’t answer (e.g. tax preparers).

• Providing education and take home information on next steps.

Activating, Maintaining, Using, and Renewing Coverage

Goals of O&E Programs • Help consumers understand

everything they need to do to activate, maintain, and renew coverage, as well as access care.

• Help consumers understand what to do if situation changes.

• Help consumers address any barriers to completing next steps.

Specific Techniques Assisters Use• Outlining next steps during

initial appointment and checking for understanding.

• Helping consumers identify and address barriers.

• Proactively following up with consumers to help them achieve specific tasks (e.g. remind them to renew coverage).

• Being available the entire year!

Collaboration and Sharing Across NC

• North Carolina has great collaboration among in-person assisters and other enrollment stakeholders. • Share promising practices and

ideas among IPAs. • Get expertise and insight from

many stakeholders. • Tap into different networks of

consumers. • Collaborate on statewide and

regional efforts.

Thank you!

Alice Pollard, Health Care Access Coordinator

Brendan Riley, Health Policy Analyst

NC Community Health Center Association

Mountain Laurel Medical Centercompassionate care in YOUR community

1027 Memorial Drive, Oakland, MD301-533-3300

Mountain Laurel Medical Center

RAEN Rural Action Enrollment Network

Mountain Laurel Medical Center

• Current RAEN Partners: Mountain Laurel Medical CenterTri-State Community Health CenterHyndman Area Health CenterHealthy Howard (Connector Entity)Western MD AHEC

• Coming Soon:University of MD ExtensionMaryland Rural Health Association

…compassionate care in YOUR community

OE

1

Mountain Laurel Medical Center

RAEN was a response to: Poor QHP Results “Border Issues” Lack of Attention to

Rural Fragmented Efforts FQHC’s Feeling “Left

Out” in MD

• Medicaid: the Notable Success

OE 2

Mountain Laurel Medical Center

•Network Planning Grant• RAEN Started October 2014:

Study the System Voice for Western MD Voice for FQHC’s Focus on Consumer

Assistance Workers Create the Right

Partnerships Capture Local Wisdom Work Effectively Across the

Borders Educate Consumers

OE

3

Mountain Laurel Medical Center

• Rich Collaboration Unfunded Partner MOU

More than Tripled # of Navigators

Certifying Staff for both MD & FFM All FQHC’s Can Assist Across

Borders Rural Wrap-Up Meeting Benefits Counseling Training

Need for Plain Language Materials

Starting Public Information Campaign Radio Crosses the Borders Best

Local + Personal + Genuine + Ongoing =

Trust

Rural consumer expects more “personal touch” and wants

ongoing relationship.

Word of Mouth

Trust is earned. Our assisters are facing a large trust burden with the ACA. FQHC’s have significant amount of trust to leverage. Perception that health insurance is unobtainable is still wide spread. Significant lack of knowledge about the ACA.

Charles Wilt, Chief Operating Officer Mountain Laurel Medical

CenterCharles@mtnlaurel.org

301-533-3300

David Stewart, Network Managerdavid@raen.org

240-979-1960

“This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number G09RH28757 and the Rural Outreach Benefits Grant Program for the grant amount of $75,000 which is 100% of the operational cost. This information or content and conclusions are those of the

author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”

Take Action

• Alert consumers about Open Enrollment. Send a dedicated email to your networks and make sure they know now is the time to sign up.

• Include information about Open Enrollment in print communication. Materials are available at http://marketplace.cms.gov

• Host an enrollment event.

• Display information in your office, business, or organization that alerts the public to open enrollment and how to get covered.

• Share information about Open Enrollment through your Facebook and Twitter accounts.

Just a Reminder

• November 1, 2015: Open Enrollment for 2016 Marketplace coverage begins.

• December 15, 2015: Deadline to enroll for coverage starting January 1, 2016.

• January 15, 2016: Deadline to enroll for coverage starting February 1, 2016.

• January 31, 2016: Last day of Open Enrollment for 2016 Marketplace coverage.

• Marketplace Information and Enrollment o https://www.healthcare.gov/

• Provider and Partner Marketplace Resourceso http://marketplace.cms.gov

• From Coverage to Care Resourceso http://marketplace.cms.gov/c2c

• HIV/AIDS Bureau Affordable Care Act Websiteo http://hab.hrsa.gov/affordablecareact

• Health Centers and the Affordable Care Act o http://bphc.hrsa.gov/about/healthcentersaca

• Federal Office of Rural Health Policy Affordable Care Act Websiteo http://www.hrsa.gov/ruralhealth/affordablecareact/

Resources