Outreach Intervention
Conditions
Brief summary
Facilitated enrollment offers a potential solution to some administrative burdens and choice frictions that may produce incomplete take-up of marketplace coverage. Because Covered California, California's ACA individual marketplace, and Medi-Cal, California's Medicaid program, share an eligibility system, Covered California has the ability to identify individuals who are eligible for marketplace coverage upon losing Medicaid eligibility. This evaluation will compare the effectiveness of facilitated enrollment strategies, including personalized plan pre-selection and personalized quotes of net premiums, to other enhanced, but general outreach tactics, on marketplace take-up among individuals losing Medi-Cal coverage.
Interventions
BEHAVIORALInformational flyer
In addition to a standard eligibility notice informing participants of their eligibility for marketplace coverage, they receive an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays
BEHAVIORALModified eligibility notice with plan information
a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount in addition to the informational flyer and instead of a standard eligibility notice
Sponsors
Covered California
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Individual in a single-member household * Discontinued from Medi-Cal * Eligible for Covered California program * Ineligible for APTCs on initial application * Did not attest to planning to file taxes within their Covered California application
Exclusion criteria
* Consumer case is no longer active within the application system * Consumer is already actively enrolled in a marketplace plan * Consumer has already restored Medi-Cal eligibility * A consumer's Special Enrollment Period has ended * Consumer is no longer listed as a single-member household * Consumer was procedurally denied from Medi-Cal coverage due to no response * Consumers has a MAGI Medi-Cal income less than 138% of the Federal Poverty Level (FPL)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Enrollment | within calendar year since the loss of Medicaid | a binary indicator for whether a consumer has at least one month of effectuated coverage a Covered California plan that started within the 90 days of their Special Enrollment Period (SEP) following loss of Medi-Cal coverage |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Uninsured | within 1-2 years from the treatment assignment | A binary indicator for whether someone self-reported being uninsured while filing their taxes; |
| Consumer engagement | within 90 days from the treatment assignment | A binary indicator for consumer engagement including calls to service center, creation of and logins to user account, plan shopping on the website, agent delegation after eligibility determination; |
| Office visit | during 1-2 years since the treatment assignment | A binary indicator for whether someone had an office visit to the medical practitioner during 1-2 years since the intervention; |
| Tenure | within 1-2 years after treatment assignment | Tenure with Covered California (measured in months) |
| Emergency room visit | during 1-2 years since the treatment assignment | A binary indicator for whether someone had an emergency room or department visit during 1-2 years since the intervention |
| Hospital admission | 1-2 years before and during 1-2 years after the treatment assignment | A binary indicator for whether someone had a hospital admission 1-2 years before and during 1-2 years since the intervention |
| Out-of-pocket health care spending | during 1-2 years since the treatment assignment | Total out-of-pocket spending for the 1-2 years since the intervention |
| Prescription filled | during 1-2 years since the treatment assignment | A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention; |
Countries
United States
Outcome results
None listed