Be community-centric and culturally competent

Open enrollment 2016: Best practices and lessons learned [Special Report]

By Leslie Small

Just as every health insurance customer is different, Enroll America has found that every open enrollment period has its own unique attributes and challenges.

The third time around, the nonprofit outreach organization has generally found that the remaining uninsured "really want health insurance," Sophie Stern (right), deputy director of the Best Practices Institute for Enroll America, told FierceHealthPayer in an exclusive interview.

About half of the remaining uninsured who qualify for coverage on the exchanges are people ages 18 to 34, Department of Health and Human Services Secretary Sylvia Mathews Burwell has said, and about one-third are members of minority groups. 

So to reach these consumers, Enroll America leans on partnerships with community colleges and historically black colleges as well as working with local community leaders to reach out to minority populations with culturally competent messages, according to Stern.

In the final stretches of this year's open enrollment, Enroll America has also teamed with HHS to coordinate a strategy to reach the Latino population. This community suffers from health disparities such as asthma, diabetes and certain cancers, Burwell said on a call with reporters, "but with better access to annual checkups, diet counseling and many cancer screenings, we can begin to close these gaps."

To reach lower-wage workers, Enroll America partners with taxi cab associations, food banks, community health centers, the Department of Motor Vehicles and even utility companies--entities that "touch everyone," as Stern puts it.

Fifty-four percent of the still-uninsured have visited a "safety net" service such as a food bank or the unemployment office in the last five years, a June analysis from the Kaiser Family Foundation (KFF) found.

Enroll America also is constantly refining its messages to see what resonates best. In this effort, the group has learned that language matters--a sentence structure can dramatically change whether someone opens an email or stays on the line with a coordinator, Stern points out.

And given that many remaining uninsured have never visited the Affordable Care Act marketplace and don't know about premium tax credits, as the KFF analysis found, Enroll America this year is taking extra care to emphasize the fine for declining coverage as well as the availability of financial assistance.

In the first open enrollment period, neither Enroll America nor the federal government wanted to scare people away from the exchanges by talking too much about the penalty, which is set to increase this year to $695 or 2.5 percent of household income.

"But we actually learned that the fine is pretty motivating," Stern said.