Going for the Gold: Using All Tools Available to Help Consumers Connect to Coverage

Just as millions of people are crowding the streets of London for the 2012 summer games, millions of people are expected to access new coverage opportunities when Exchanges open for business next year. Preparing for the influx of people who will gain new coverage options requires the same kind of careful planning and preparation as we’ve seen in London, and deployment of every tool possible to make the experience smooth and efficient.

If you follow “Say Ahhh,” you know I’m a big fan of outreach and direct enrollment assistance to help people connect to coverage. But as diverse as Olympic sports, states have many ways to help consumers connect with coverage. To explore additional opportunities to boost consumer assistance, Jessica Kendall, Outreach Director at Enroll America, and I teamed up again on this new brief, “Consumer Assistance in the Digital Age: New Tools to Help People Enroll in Medicaid, CHIP and Exchanges.” (A special thanks to our friends at the Maximizing Enrollment Project who asked us to carry the torch on this project. Maximizing Enrollment: Transforming State Health Coverage is a national program of the Robert Wood Johnson Foundation (RWJF) and is administered by the National Academy of State Health Policy.)

Making the most of technology can maximize limited resources. One focus of the brief is how states can use technology to support consumers applying on their own online. Given the large number of people accessing coverage, facilitating self-service for consumers will not only enhance their experience but also reserve limited state and community resources for those who need a human touch most. Technology-based tools such as e-communications, chat and online accounts offer low-cost ways to assist consumers using web-based services. As states move forward in building their new online eligibility and enrollment systems, maximizing the use of these new consumer assistance tools will be both strategic and cost-effective.

Getting to “no wrong door” means integrating the old and the new.  Our brief isn’t just about these new tools. It discusses the multiple “no wrong door” paths to enrollment and renewal – online, over the phone, via the mail and in person – and how states can integrate the new tools with more traditional assistance through navigators, state agencies’ consumer assistance staff and other community-based assisters. Ultimately all pathways lead to the new eligibility and enrollment systems so that consumers benefit from electronic verification of eligibility, real time eligibility decisions and one-step enrollment. One notable finding of our study is that state officials believe the transition from paper to electronic-based eligibility will take time. So we identified 10 ways to drive up the volume of electronic applications noting, for example, the critical importance of a separate portal for navigators and enrollment assisters to facilitate applications and the availability of mobile applications for people who are more likely to use smartphones or tablets than computers.

Visualize the finish line and cross-train with others.  Transforming the eligibility and enrollment process, working with navigators, operating call centers, providing in-person assistance and coordinating with Exchanges mean substantive changes for Medicaid and CHIP agencies. In preparing for the changes ahead, leadership and teamwork matter and an effective communications plan and stakeholder engagement strategy (including current staff) is critical to achieving new expectations for high-quality customer service, the vision for a simple, streamlined process and a first class consumer experience. States may find that pooling their resources to integrate consumer services among the various agencies will not only be cost-effective but also result in higher-quality customer service, greater consumer satisfaction and more continuous coverage.

Athletes know there is no single path to success in their quest for a medal. For the foreseeable future, technology will not replace the need for personalized consumer assistance. States that go for the gold by integrating new technology-based tools with tried and true ways of assisting consumers will help all all consumers cross the finish line in their pursuit of coverage.

Tricia Brooks is a Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.