“This has been moving at lightning speed, and it makes really big changes to our healthcare system,” said Cindy Zeldin, executive director of Georgians for a Healthy Future.
Recently released HHS numbers show that health insurance enrollment in Georgia and across the country is going strong. The Affordable Care Act is what has made these coverage gains possible, yet Congress has prioritized repealing this landmark legislation without clarifying what would replace it. We need your stories and your voice to ensure our policymakers understand the consequences of repealing the law. Please consider submitting your story, or the stories of the people that you serve, of how the ACA has benefited you. Whether it’s being able to afford coverage through the availability of tax credits, not being denied coverage due to a pre-existing condition, or being able to stay on a parent’s plan until age 26 – we need to hear from you!
Georgians for a Healthy Future is now several weeks into our training partnership with Enroll America. As you might recall, Enroll America selected GHF as the first organization, nationally, to participate this year in the Leadership Academy in a train-the-trainer model. Enroll America is using the Leadership Academy train-the-trainer model to disseminate their expertise on how to conduct trainings with Enroll America information in order to reach a wider audience.
We have covered topics including list building, reaching the remaining uninsured, and how to design a follow up program. Pranay Rana, GHF’s Consumer Education and Enrollment Specialist, is currently planning several trainings that will take place in October to start the process of imparting our new knowledge to partner organizations. We will also be adding some of the Enroll America training content to our GEAR emails, so keep an eye out for new information on best practices for reaching uninsured consumers, building an outreach plan, and more!
If you have any questions or would like to learn more about the partnership please reach out to Pranay.
Last week, Georgia health advocates, service providers, and enrollment assisters combined forces for a day of learning, sharing, and planning at our second annual Getting Georgia Covered summit. In conjunction with the event, Georgians for a Future released a new publication focusing on key themes in consumer and assister experiences during the 2016 open enrollment period, best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured, and policy opportunities to increase enrollment, improve access to care, and address affordability issues. The report, Getting Georgia Covered: What We Can Learn From Consumer and Assister Experiences During the Third Open Enrollment Period, is intended to be a resource for health care stakeholders, advocates, and policymakers.
In addition to workshops that fostered collaboration between organizations and individuals working on behalf of health care consumers in different ways, we also featured presentations and remarks from Dr. Pamela Roshell, Region IV Director, US Department of Health and Human Services, Dr. Bill Custer, Director of Center for Health Services Research and Associate Professor, J. Mack Robinson College of Business, Georgia State University, Heather Bates, Deputy Director, Enrollment Assister Network, Families USA and Sandy Anh, Associate Research Professor, Georgetown University Center on Health Insurance Reforms. Jemea Dorsey, Chief Executive Officer for the Center for Black Women’s Wellness, and Sarah Sessons, Executive Director of the Insure Georgia Initiative of Community Health Works also offered their expertise and insights in a closing panel. In the coming weeks, we will release a publication highlighting promising opportunities to improve consumer health through collaboration, drawing on the discussions and ideas that came out of the workshops and discussions.
Georgia’s rate of uninsured children has dropped from 11 percent during the depths of the recession to 7.6 percent in 2014. Despite this improvement, that means that 189,000 Georgia kids do not have access to needed health care and their families are without the financial protection that comes with coverage. In order to address this need, people who regularly work with children need to be aware of the importance of health coverage to children, and have the resources they need to connect kids and families with coverage quickly and easily.
That is why GHF partnered with the Georgia Departments of Education and Public Health to conduct a webinar called “Covering Kids.” The webinar was created for school nurses because they are such important sources of health information for families and students. During the webinar, Laura Colbert, Director of Outreach and Partnerships, reviewed the short and long term benefits of health care coverage for kids, which include academic and economic benefits on top of improved health outcomes. She also discussed trends and current statistics on children’s coverage in Georgia, and highlighted the pathways to coverage for kids which vary based on family income. Most importantly, she identified valuable community resources so that school nurses across the state can connect families and children with local assistance and information to help get them enrolled. This webinar is available to view on the School Nurse Exchange, and nurses who complete the webinar and an evaluation can receive CEU credits.
For more information about children’s health care coverage, check out these resources:
With three annual open enrollment periods completed and a fourth one just around the corner, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for roughly half a million Georgians. This report builds on last year’s Getting Georgia Covered: Best Practices, Lessons Learned, and Policy Recommendations from the Second Open Enrollment Period and focuses on understanding the characteristics of the people who have enrolled in marketplace plans and the experiences of consumers and the enrollment assisters who helped them. Their insights can inform the work of advocates, stakeholders, and policymakers to reach shared goals of reducing the uninsured, improving access to care, and addressing affordability for consumers.
Inside you’ll find:
- Key themes in consumer and assister experiences during the 2016 open enrollment period
- Best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured
- Policy opportunities to increase enrollment, improve access to care, and address affordability issues
Does a strong consumer voice make a difference in health policy outcomes? According to a Mathematica Policy Research evaluation of state-level consumer health advocacy projects supported by the Robert Wood Johnson Foundation (RWJF), yes!
At Georgians for a Healthy Future, consumer engagement is woven into each of our initiatives to bring the needs – and voices – of Georgia health care consumers into the public policy process. Over the past two years, one of our top priorities has been maximizing health insurance enrollment and ensuring that, once enrolled, consumers can access the care they need. Our work in this area, along with that of similar efforts in seventeen other states, was recently evaluated by Mathematica. The evaluation focused on the activities and outcomes of the eighteen Consumer Voices for Coverage (CVC) projects funded by RWJF.
Georgians for a Healthy Future was a CVC grantee in 2014-2016. Through this program, we focused on outreach, education, and enrollment in coverage and used this work to inform and strengthen our policy work. The CVC evaluation found that coalitions, such as the one led by GHF in Georgia, played a central role in successful outreach, allowed consumer advocates to work together to help maximize enrollment and retention, and helped identify policy issues needing attention.
These coalitions worked to increase enrollment in health coverage programs by building alliances with diverse stakeholders, mobilizing and engaging consumers, identifying achievable policy options to address issues arising from consumer experiences, designing and implementing communication strategies, and securing resources to sustain these efforts.
While the CVC program is winding down, Georgians for a Healthy Future’s work in this area will continue through our Georgia Enrollment Assistance Resource (GEAR) network and through our ongoing policy work around coverage, access to care, and health care value. As we continue this health policy and advocacy work, we will leverage the advocacy infrastructure and ability to translate consumer voices strengthened through CVC into concrete policy actions.
To read the complete Mathematica evaluation, click here.
The weather is heating up and the official start of summer is just around the corner, but here at Georgians for a Healthy Future we’re already looking ahead to one of the hallmarks of fall: open enrollment! The fourth health insurance open enrollment period, known as OE4, will run from November 1, 2016 through January 31, 2017. Stay tuned for an announcement soon about our enrollment summit – an opportunity for Georgia assisters, advocates, and other enrollment stakeholders to reflect on OE3 and plan for OE4 – scheduled for this coming August.
Earlier this spring, new renewal policies and consumer shopping tools were announced (see a roundup of these changes from Georgetown University’s Center on Health Insurance Reforms) and health insurance plans released their initial rate filings (see Georgia Health News’s coverage here, including comments from GHF’s Executive Director Cindy Zeldin), giving us early insights into what we might expect in the upcoming open enrollment period. It’s important to keep in mind that initial rate filings provide important information to regulators, stakeholders, and consumer advocates but they aren’t a good predictor of what consumers will actually pay for health insurance this fall. That’s because proposed rates must first undergo scrutiny by regulators and don’t take into account consumer shopping behavior or the availability of premium tax credits.
While we’re busy preparing for OE4, we also know that health insurance enrollment does happen year-round (if you are engaged in enrollment activities this summer, please tweet about them using #enrollment365). Life changes like marriage, moving, or job loss can happen during any season, triggering special enrollment periods (SEPs). Awareness of SEPs is low, and assisters play an important role in helping consumers who qualify navigate the process. Despite low enrollment during SEPs, however, the Centers for Medicaid and Medicare Services (CMS) recently issued a new rule further tightening them. GHF is concerned these changes could dampen enrollment among qualified uninsured individuals. If you are an assister and are finding that qualified individuals are having difficulties enrolling in an SEP, please let us know.
Finally, if you or your organization helps consumers navigate the health coverage or health care landscape, please consider joining GEAR, the Georgia Enrollment Assistance Resource network. GHF formed GEAR last year to help members of Georgia’s enrollment community learn from each other, share consumer-facing educational materials, and stay apprised of best practices from around the country. Joining GEAR is free, and through it we provide networking and learning opportunities for individuals and organizations that assist health care consumers. And it helps GHF keep our finger on the pulse of what consumers and assisters are experiencing so we can be better advocates. Learn more here.
Georgians for a Healthy Future teamed up with the US Department of Health and Human Services Region IV and Enroll America to bring enrollment assisters together to learn what went well, what could be improved upon, and what groups were planning for the next open enrollment period starting this coming fall. We had great participation from all the partners in attendance — stay tuned for some materials highlighting key themes from the discussion in the coming weeks! If you are an enrollment assister or work on health insurance enrollment in Georgia, please join our GEAR network to access helpful materials and engage with your colleagues!
Provider directories, or the listing of health care providers that are participating in a particular health plan, are intended to inform patients and consumers about which doctors are in their plan and how they can contact them to set up an appointment. For these directories to serve as the tool that consumers need, they must be accurate and up-to-date. A secret shopper survey conducted by the statewide consumer health advocacy organization Georgians for a Healthy Future, however, found these directories to be error-ridden, a problem that places consumers at risk when they seek to access an appropriate in-network health care provider. An analysis of four provider directories associated with plans offered by three of the state’s largest insurers found:
» Three-quarters of the listings had at least one inaccuracy (not in-network, not accepting new patients, not practicing at the location listed, inaccurate or inoperable phone number, or languages spoken inaccurately listed)
» One in five health care providers listed as participating in a plan’s network were not; in one directory forty percent of the providers listed were not actually participating in the plan » Among the providers who were confirmed to be in-network, thirteen percent were not accepting new patients; in one directory one in four confirmed in-network providers were not accepting new patients
» Fifteen percent of telephone numbers associated with providers listed in the directories were inaccurate or inoperable
These inaccuracies and usability limitations make it difficult for health care consumers, particularly those who haven’t had insurance before, to find and access an appropriate medical care provider. Setting basic standards for provider directories and protections for the consumers who rely upon them would go a long way towards making provider directories the tool that patients and consumers need when they shop for and use their health insurance.
Download the full set of findings here.
We want to hear from you – new SEP rules
At the beginning of last year’s open enrollment period, GHF created GEAR, the Georgia Enrollment Assister Resource Network (GEAR). GEAR is a coalition of enrollment assisters and those closely involved in the enrollment process. Now the open enrollment is passed, GEAR is turning to tax time and special enrollment periods (SEPs). Last month, CMS announced the new special enrollment confirmation process. Georgians will now be required to provide sufficient proof to the marketplace to determine their SEP eligibility. Failure to provide supporting documents may lead to the denial of coverage. At GHF we advocate for policies that make enrollment in health insurance more inclusive and fight policies that put up unnecessary barriers. We want to hear from you about this! If you’re an enrollment assister and are experiencing trouble enrolling consumers during a special enrollment period, let us know! If you’d like to join the GEAR network, you can do that here.