Enroll America and private web entities could be avenues for new exchange customers
Even the White House admits that average Americans are unfamiliar with the Patient Protection and Affordable Care Act.
“Because there is so much misinformation some people might not have a sense of what the law actually does,” President Obama said at a briefing in May.
If consumers remain so deeply in the dark in the coming months, few will seek out insurance exchanges and few will have the motivation to sign up for health plans this fall. Awareness programs and marketing campaigns will need to be frequent and memorable to convince consumers to fully make their way to the point of enrollment.
“The challenge the exchanges are going to have is the outreach program,” says Sam Gibbs, president of eHealth Government Systems, operator of an online private exchange. “So the law gave them some tools to work with like navigators to help people learn a bit and point them in right direction.”
EHealth, which has brokered an online health insurance marketplace for 14 years, tallies 15 million visits per year to its portal and has signed up 3 million enrollees. And according to Gibbs, federally operated and state exchanges can actually ride on the coattails of portals like eHealth that are already in place.
Specifically, states can appoint certified “web-based entities” to supplement the state exchange efforts and enroll individuals and families-including those in subsidized populations, Gibbs says. If chosen by the states, the web-based entities would be parallel portals offering the same options as the exchanges but could possibly offer other insurance products, too.
The state and federally operated exchanges will not provide any funding, fees or commissions to the private web-based entities.
Department of Health and Human Services regulations released in March indicate that exchange-plan premiums in such private, supplementary exchanges must be identical to those in the corresponding state or federal exchange. The entities also must offer the full choice of exchange products, whether the carriers or products participate separately with the private exchange or not.
Some consumers could choose a plan product originating from the private entity rather than the state-based exchange. However, those cashing in on subsidies would ultimately enroll in a qualified health plan product.
Anne Filipic, president of Enroll America, the not-for-profit advocacy group drumming up awareness of coverage options, says the group will launch the “Get Covered America” program this summer.
“To us, that means working with a broad coalition of stakeholders and having staff on the ground to communicate with consumers,” Filipic says.
Outreach elements will include paid advertising, toolkits for community groups and social media. She says it’s important to reach consumers through channels they naturally access such as websites, health centers and church communities.
Amid some controversy, Kathleen Sebelius, a federal health official, was questioned about whether she was promoting financial support of Enroll America, which is a private organization. She reportedly asked at least two heathcare companies to support the organization in outreach activities but denied asking for financial contributions.
Enroll America has already created preliminary materials for stakeholders including “Spring Training” videos online.
Filipic says one segment that might be harder to reach is the young male population. According to the group’s research, young men will pay attention to messages from their mothers, so reaching them is also a matter of reaching their mothers. She suggest providing information they can download and pass along.
Gibbs says marketing programs to drive consumers toward enrollment must be broad and deep. Links and online advertising are the most obvious way to draw in consumers but television, radio and mail campaigns can underscore the messages.
“By 2015, exchanges have to be self-funded,” Gibbs says.
Most will use a fee-based model in which insurers pay to participate in the marketplace, and the funding will be used to maintain the infrastructure and support staff. Individual states have target enrollments ranging from 118,000 to 2 million people, so fee structures could vary widely.
Filipic says Enroll America is working with payers such as Kaiser Permanente and Blue Shield of California to share outreach information. Plans hope to gain members through the outreach efforts but they will also do their own brand-specific marketing, she says.
State decision makers that operate their respective exchanges might still have some work to do. The name of the exchange will become a brand unto itself, such as “Covered California” and Massachusetts’ “The Connector.”
Lake Research Partners conducted two surveys for the Washington state exchange board and found:
• Consumers are confused by the word “exchange” and some believe it implies they have to trade current coverage for something else;
• Those who are uninsured or likely to become uninsured are skeptical that an insurance plan exists for them so the word “insurance” does not resonate well; and
• Exchanges must be neutral, and the word “insurance” could make consumers think the exchange is a product of a particular insurer.
Extending the Capabilities of the EHR Through Automation
August 2nd 2023Welcome back to another episode of "Tuning In to the C-Suite," where Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of chatting with Cindy Gaines, chief clinical transformation officer at Lumeon.
Listen