Reprinted from AIS's HEALTH REFORM WEEK, the nation’s leading publication on the business implications of the massive changes for the health industry mandated by reform.
By Neal Learner, Editor
May 20, 2013 Volume 4 Issue 10
While the big marketing push is expected later this summer, some states and private insurers, along with the federal government, already are launching consumer-awareness campaigns to promote the insurance exchanges that start in October. Colorado and a multistate Blues operator are among the players getting an early jump on finding and encouraging millions of uninsured individuals to seek coverage. HHS also recently released guidance on how agents and brokers should sign up people, and announced it would provide $150 million for community health centers to provide enrollment assistance.
These efforts come amid increasing attacks by Republicans — and nervousness from some Democrats — that far fewer people than expected will purchase plans offered on the exchanges.
A top official involved in Massachusetts’ 2006 effort to enroll individuals tells HRW that there is still plenty of time to attract people for enrollment. But others say no efforts should be spared at this point to ensure that the next phase of the Affordable Care Act (ACA) is successful.
“It’s all hands on deck,” says Timothy Jost, a professor at the Washington & Lee University School of Law and consumer adviser to the National Association of Insurance Commissioners.
“We need everybody we can to get people signed up, because many of these will be people who have not traditionally bought health insurance, and they’re going to be — some of them — pretty hard to reach,” he tells HRW. “Many of them don’t speak English, many of them have limited reading capacity, many of them have limited ability to deal with numbers, and many of them don’t have access to computers. We really need to get out there and find them.”
These are among the factors behind Colorado’s May 6 launch of a $2 million ad campaign to introduce residents to the state’s online marketplace, known as Connect for Health Colorado. The campaign, which is the first state outreach effort around the ACA’s exchanges, features television, print, radio and billboard ads.
A similar consumer outreach effort is under way by Health Care Service Corp. (HCSC), which operates Blues plans in Texas, Illinois, Oklahoma and New Mexico.
The “Be Covered” campaign, launched this spring, stems from HCSC research that shows the vast majority of the uninsured in its markets are confused about the ACA, have little experience with the insurance industry, and need help understanding how they can connect to health care services in general, says HCSC spokesperson David Sandor.
“Before engaging in product marketing, we believe that basic education is needed to address the knowledge and experience gaps our research uncovered,” he tells HRW. “To gain traction with so many people in such diverse communities, we had to start early and establish relationships with credible community organizations that could reach and motivate people.”
The Be Covered campaign provides a grassroots infrastructure for education and ongoing discussion, Sandor explains.
“You cannot approach this as a mass advertising sprint through an open-enrollment period. To succeed will require a social marketing marathon fueled by a sophisticated understanding of diverse cultures, demographic trends and differing value propositions,” Sandor says, likening the effort to long-term campaigns around seatbelt use and eating a balanced meal.
Colorado’s and HCSC’s efforts likely will be welcomed by federal officials who have a limited budget to publicize the exchanges. Despite requesting $249 million from Congress for consumer-outreach efforts, HHS received just $54 million for the Navigator program, which will help consumers understand and find coverage options on the exchanges (HRW 3/25/13, p 1).
The lack of federal funding is a major concern, says Jost. “It’s distressing that on the one hand the opponents of ACA are doing everything they can to starve it of resources to make it very difficult, if not impossible, to do its job,” he asserts. “And on the other hand, they’re saying, ‘it’s a train wreck, they’re not getting it done.’ I don’t know what you do in that situation other than soldier on.”
Republicans in Congress have been unwilling to allocate new money to finance government outreach efforts. And even Democratic Sen. Max Baucus (D-Mont.), Senate Finance Committee chairman and an architect of the ACA, worried that the rollout could result in a “train wreck.”
Aiming to avoid this outcome, HHS said on May 9 that it would use $150 million in new funding to hire staff, train existing staff and conduct outreach events and other educational activities through the nation’s roughly 1,200 community health centers, which serve approximately 21 million patients per year.
“Health centers have extensive experience providing eligibility assistance to patients, are providing care in communities across the nation, and are well-positioned to support enrollment efforts,” said HHS Sec. Kathleen Sebelius.
These workers will be seeking out a public that is still mostly unaware of the exchanges. A recent Kaiser Family Foundation survey found that 77% of people know little or nothing about them.
President Obama did his part to raise awareness of the exchanges during a May 10 speech that showed how the ACA was especially benefiting women. Obama acknowledged that some people are anxious about the effort to date. “So I’m here to tell you, I’m 110% committed to getting it done right,” he said. “It’s not an easy undertaking, but if it were easy, it would have already been done a long time ago.”
Furthermore, CMS this month released guidance on the role of agents and brokers in educating and enrolling consumers through the federally facilitated and state partnership marketplaces (see chart, below).
According to the guidance, agents or brokers appointed by the insurer can initiate enrollment of a consumer through the insurer’s website without having to show all of the plans that are available through the exchange, Jost says.
“It’s going to get producers and insurers more excited about trying to use the exchange and getting people signed up,” he says. “On the other hand, one of the major purposes of the exchange was to create a competitive marketplace. If all you’re seeing are the Blue Cross plans or the United plans or the Aetna plans, that’s not a competitive marketplace, that’s preserving the kind of market concentration we already have in health insurance.”
The guidance does say that the agent or broker has to inform the consumer of his or her right to go to the exchange website and see all of the options. “But there is always the problem, are they going to mutter that under their breath, put it in fine print, or is it going to be right up there out front?” Jost says.
Mass. Offers Glimpse of Enrollment Outcome
The 2006 health reform law in Massachusetts, which served as the model for the ACA, may offer a glimpse of how efforts around awareness and enrollment might play out this fall and into 2014.
The state and the private sector launched major advertising campaigns leading up to implementation of the Massachusetts law, which, like the ACA, required everyone to obtain insurance or pay a tax penalty, says Patricia Andriolo-Bull. She is the former director of Commonwealth Choice at the Massachusetts Health Connector and now vice president of payer business development at consulting firm athenahealth.
The effort included all types of media, including television and radio, she tells HRW. One of the most effective campaigns, especially to reach the “young invincibles,” involved a partnership with the Boston Red Sox. “If you know anything about Massachusetts, that’s a really good way to capture people’s attention,” she says.
Andriolo-Bull contends there is still plenty of time to gain people’s attention and enroll them in the fourth quarter and early 2014.
“I think as people get back into school and parents get back into a rhythm and kids go back to college, you’re going to capture more people through an advertising campaign,” she says. “September probably makes the most sense if you want value for your dollar. It’s soon enough and they’ll start hearing about the exchanges, and there will actually be exchanges that they can start thinking about, and you can tell them where to go and they can get information.”
http://aishealth.com/archive/nref052013-03
No comments:
Post a Comment