Community organizations critical to enrolling the uninsured in subsidized health insurance, UMass Medical School report says

June 01, 2016

Community-based organizations play a critical role in enrolling the remaining uninsured in publicly subsidized health insurance and promoting consumer self-sufficiency, according to a report authored by UMass Medical School and released by the Blue Cross Blue Shield of Massachusetts Foundation (BCBSMA Foundation).

The 2013-2015 Connecting Consumers with Care Grant Area Evaluation, released June 1, describes the experiences, successes and challenges faced by the 16 participants in this grant cycle of the Connecting Consumers with Care program. Funded by the BCBSMA Foundation, the program supports health centers, public agencies and community organizations that help consumers enroll in subsidized health insurance.

The Center for Health Policy and Research, a unit within UMass Medical School’s Commonwealth Medicine division, conducted the evaluation and wrote the report. The co-authors are: Deborah Gurewich, PhD, associate director of research and evaluation and an assistant professor in UMass Medical School’s Department of Family Medicine and Community Health, Linda Cabral, MM, senior project director, and Laura Sefton, MPP, project analyst. The Massachusetts Area Health Education Center (MassAHEC) Network, part of the Center for Health Policy and Research, provided technical assistance and a learning community to the participants.

Key findings are that the organizations in the 2013-2015 grant cycle of the program: 

  • Assisted nearly 90,000 consumers in submitting health insurance applications.
  • Supported 35,675 consumers each quarter with the enrollment process, including creating an account, selecting a plan or making an appointment with a primary care physician.
  • Provided more than 290,000 encounters with consumers during the reporting period.

The report says the participants accomplished the findings through media campaigns; partnering with local organizations, including correctional facilities, career centers and food pantries; and providing in-person assistance with the application process on-site and off-site. The organizations increased staff and work hours when necessary to meet the demand for services, completed paper applications when the online service wasn’t working during the first Affordable Care Act open enrollment period, and reached out to those with temporary coverage when they needed to re-enroll.

Three barriers were reported by the participants: the number of consumers needing help with applications exceeded the capacity of the sites, the complexity of the enrollment process, and a language barrier for consumers who speak languages other than English or Spanish.

In this grant cycle, the BCBSMA Foundation emphasized the importance of helping consumers navigate their health coverage and care with increasing independence. The grantee organizations advanced consumer self-sufficiency with strategies that included education, written guides, and training in how to enroll in and maintain insurance coverage.

The experiences of the organizations in the program can be a source of important information to other organizations nationwide that are involved in outreach, enrollment, and post-enrollment efforts, according to the report.

The goals of the evaluation were to assess grantee performance with respect to consumer outreach and enrollment; describe the practices grantees adopted to reach and enroll consumers in insurance; and to characterize grantee efforts and challenges involved in implementing and evaluating strategies to help consumers navigate health coverage and care with increasing independence.

The BCBSMA Foundation has offered its Connecting Consumers with Care grant program since 2001. The program has been extended through September 2017.

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