Health insurance navigators play a vital role by educating consumers, increasing health insurance literacy, and facilitating enrollment, said Cindy Zeldin of Georgians for a Healthy Future.
This August, GHF invited both advocates and enrollment assisters to the second annual Getting Georgia Covered summit. Bringing these two groups together was the first step in fostering ongoing conversations and partnerships to ensure that health coverage translates into meaningful access to care for Georgians. Through the summit, GHF collected feedback and input for a report that highlights how assisters and advocates can team up for consumers. We invite you to read and share Collaborating for Consumers: How Assisters and Advocates Can Inform Policy, in which you will find opportunities and best practices for collaboration to achieve our shared goals.
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.
Direct consumer support plays an important role in assisting consumers to enroll into and maintain their health coverage. Georgians for a Healthy Future, primarily a health advocacy organization, provided direct enrollment services to Georgians in the last two open enrollment periods through enrollment events, in-person appointments, phone assistance and referrals. GHF continues to engage with other enrollment entities through its Georgia Enrollment Assistance Resources (GEAR) network which is a central hub of Marketplace resources, and provides technical support to assisters through newsletters, e-blasts, trainings, webinars, and forums.
In OE3, GHF primarily focused on post enrollment work undertaking more complex consumer cases such as resolving coverage issues with the Marketplace and insurance providers, payment issues, tax filing and reconciliation issues, and issues with supplemental documents. In this role, GHF provided crucial support to consumers and enrollment assisters to resolve these types of issues and help consumers maintain their coverage.
Here is what our consumers reported about their experiences
GHF conducted a post-enrollment consumer satisfaction survey with 25 consumers between April and July 2016. The survey participants reported that they sought a combination of services during their appointments. The table below provides the details for each type of post-enrollment assistance.
Twenty-four out of 25 (96%) participants reported that they were able to resolve the issues that they sought assistance for, as explained by these quotes…
“Paid my premium, sent supplemental documents, added two kids to the application, received delayed cards” – Res# 1, Female, 30.
“My coverage had been suspended for over a month due to a technical issue. GHF helped me reinstate my suspended insurance by advocating on my behalf with both Marketplace and Ambetter. My benefits were reinstated within 3 business days”— Res# 16, Female, 62.
GHF Success Stories:
Tony Caldwell, a consumer with disability, was waiting to get his power wheelchair for over a year. With direct enrollment support from GHF, he was able to get his application completed during SEP and select a plan that covered his wheelchair. Tony quotes, “I finally ended up getting my power wheelchair that I had been waiting for over a year. It has helped me from passing out. Thanks to you all.”
Clyde Mohammed and his wife Sharda (West Indian couple) came to renew their marketplace plan at Switzer Public Library in Marietta. They also wanted to change their current plan since the premium was going up in 2016. Assisted the consumers to complete their application. They were found eligible for subsidies. They enrolled into a health plan with $57 monthly premium and $600 family deductible. The family was able to save over $150 in monthly premium by switching their plan.
The majority of the participants reported the Marketplace application process to be very complicated and that they couldn’t have resolved their issues without the help of an enrollment assister. Those participants who found the process to be comfortable reported the assistance they received to be the key reason. Participants also reported that the education from enrollment assisters made it easier for them to understand and use their new health insurance.
Trends from our direct consumer support experiences and those we have heard from our partners suggested that direct enrollment assistance was crucial for consumers in making enrollment decisions as well as tackling post-enrollment issues. Direct assistance will continue to be crucial for consumers, both new enrollees and re-enrollees, in the days to come as there will be changes in participating insurance providers, premium price, and personal details such as household size and income all of which will require enrollment assisters’ expertise.
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.
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 staff attended the Connections 2016 conference hosted by the Healthcare Georgia Foundation on March 29th and 30th. The conference, held every other year, is an opportunity to network and learn from Georgia’s health and public health practitioners, professionals, advocates, and experts.
This year’s conference theme was partnerships, and in keeping with that theme, GHF was invited to present on how we use coalition building and mobilization as a strategy for policy change at the state level. Cindy shared how our history created an organizational environment that fosters and supports the development of strategic partnerships and coalitions. Laura added to that with an overview of GHF’s five coalitions, a coalition case study, and a review of some selected best practices in coalition development and management. You can see their presentation here.
As a result of the two-day conference, GHF staff came away with new contacts to partner with in the future and new ideas about what partnership might look like. The conference also provided the opportunity to network with existing partners, learn about their emerging work, and identify ways to collaborate moving forward.
If you would like to partner with GHF or join any of our five coalitions, contact Laura Colbert, Director of Outreach and Partnerships, at email@example.com.
- The Access to Care and Equity (ACE) coalition focuses on ensuring that coverage translates to access to care and has been working most recently on the issue of network adequacy
- The Cover Georgia coalition advocates for closing Georgia’s coverage gap that leaves 300,000 Georgians without a coverage option
- The Georgia Enrollment Assister Resource (GEAR) Network connects people and organizations working to help consumers enroll in coverage
- The Health Advocates coalition is open to health advocates representing non-profit organizations who want to coordinate efforts with other advocates
- The Preventing Youth Substance Use Disorders coalition works together to raise awareness about and advocate for a public health approach to preventing addiction
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!
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.