Putting Out the Welcome Mat: Targeting Outreach Under theAffordable Care ActPreliminary Findings from the 2012 MinnesotaCo...
Acknowledgements• SHADAC Collaborators  –   Lynn Blewett, SHADAC Director and Professor  –   Kathleen Call, Professor  –  ...
Presentation Overview• MCHA and Health Reform• 2012 MCHA Enrollee Survey• Preliminary Results  –   General characteristics...
Minnesota Comprehensive HealthAssociation• Provides health insurance coverage for the “medically  uninsurable”• Five Eligi...
High Risk Pools and Heath Reform• Short term  – State mandate to create a high risk pool or    participate in new federal ...
2012 MCHA ENROLLEESURVEY                     6
2012 MCHA Survey: Objectives• Provide information to MCHA to help transition  enrollees into new ACA coverage options  – A...
Methodology• Mail survey of 5,200 MCHA enrollees  – Policy holders enrolled for 12 months  – Excluded children and those w...
PRELIMINARY RESULTS                      9
Enrollee General Demographics• Mean age is 52 years• Slightly more females than males (53%)• Almost 60% live in an urban a...
Enrollee Self-Reported Chronic Conditions• 92% of enrollees report at least one chronic condition,  22% report more than 4...
Enrollee Experience with MCHA• More than two-thirds have been in MCHA for  more than 4 years• 23% have been in MCHA for 10...
MCHA Program Use Among Enrollees• Reports of participation in health improvement  programs were low, but those that used t...
Features of MCHA Coverage that areImportant to Enrollees80%      73%                                             Rx covera...
Coverage for a Specific Service –Top Mentions•   Annual exams, preventive services, screenings•   Chiropractic services•  ...
Reasons Enrollees Would Leave MCHA                      Primary Reason                                       Can no longer...
Reasons Enrollees Would Remain on MCHA                           Primary Reason         (for those who indicated nothing w...
Reasons Enrollees Would Remain on MCHA• Unaware of other options• Other companies will not cover my pre-existing  conditio...
MCHA Enrollees Potential Eligibility forNew Coverage Options in 2014• The majority of enrollees will likely get no federal...
Enrollee Familiarity with Health Reform100%            1%                        1% 1%                  5%90%             ...
Enrollees Worries About Changes UnderHealth Care Reform             Self Report of Worried/Very Worried                   ...
Enrollee Deductible Level by Health ReformIncome Categories                     Less than 138%                       Above...
Willingness to Enroll in a Public Program    If you learned you were eligible for a public program                 at no c...
Possible Outreach Methods     How would you most like to receive information               about coverage changes?        ...
Key Contact      Elizabeth Lukanen   Senior Research Fellow     elukanen@umn.edu         612.626.1537Sign up to receive ou...
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Pres hsr mar5_lukanen

  1. 1. Putting Out the Welcome Mat: Targeting Outreach Under theAffordable Care ActPreliminary Findings from the 2012 MinnesotaComprehensive Health Association (MCHA) EnrolleeSurveyElizabeth Lukanen, MPHSHADAC, University of MinnesotaMN Health Services Research ConferenceSt. Paul, MNMarch 5, 2013 Funded by a grant from the Robert Wood Johnson Foundation
  2. 2. Acknowledgements• SHADAC Collaborators – Lynn Blewett, SHADAC Director and Professor – Kathleen Call, Professor – Elizabeth Lukanen, Senior Research Fellow – Karen Turner, Senior Program Analyst – Heather Dahlen, PhD Student and Research Assistant• MCHA and Medica Staff• Support for this work was provided by a grant from the Robert Wood Johnson Foundation’s State Health Reform Assistance Network 2
  3. 3. Presentation Overview• MCHA and Health Reform• 2012 MCHA Enrollee Survey• Preliminary Results – General characteristics of MCHA enrollees – Experience with MCHA – Important features of coverage – MCHA enrollees and health reform 3
  4. 4. Minnesota Comprehensive HealthAssociation• Provides health insurance coverage for the “medically uninsurable”• Five Eligibility Avenues: – Loss of group coverage – Health Coverage Tax Credit (HCTC) program – Medicare ineligibility – Health-related rejection – Presumptive condition(s)• Among the longest-running and largest state high risk pools in the country – Currently, 26,000 enrollees• Administered by Medica Health Plan 4
  5. 5. High Risk Pools and Heath Reform• Short term – State mandate to create a high risk pool or participate in new federal high risk pool• Long Term 5
  6. 6. 2012 MCHA ENROLLEESURVEY 6
  7. 7. 2012 MCHA Survey: Objectives• Provide information to MCHA to help transition enrollees into new ACA coverage options – Assess potential eligibility for Medicaid and exchange – Gauge enrollee familiarity with ACA changes – Collect information to inform outreach and communication strategies• Gain knowledge of how MCHA enrollees might impact risk pools – Collect information on health status, pent-up demand 7
  8. 8. Methodology• Mail survey of 5,200 MCHA enrollees – Policy holders enrolled for 12 months – Excluded children and those with Ryan White and HCTC eligibility• Three-stage mailing• $2 incentive payment with first mailing• Oversampling of low-income enrollees and those in rural areas• Survey response rate was 50.2%• Weighting adjustments were conducted 8
  9. 9. PRELIMINARY RESULTS 9
  10. 10. Enrollee General Demographics• Mean age is 52 years• Slightly more females than males (53%)• Almost 60% live in an urban area• Less than a quarter have less than a high school education• More than two-thirds are employed or self employed• Majority report incomes above 400% FPG• 45% reporting being in very good/excellent health 10
  11. 11. Enrollee Self-Reported Chronic Conditions• 92% of enrollees report at least one chronic condition, 22% report more than 4• The most commonly reported conditions include: Condition Percent High blood pressure 33% Weight condition 30% High cholesterol 30% Allergies 29% Arthritis/osteoporosis 23% Back/neck condition 22% Mental health conditions 20% Diabetes 18% Headaches 14% 11
  12. 12. Enrollee Experience with MCHA• More than two-thirds have been in MCHA for more than 4 years• 23% have been in MCHA for 10 years or more• 16% report receiving a low-income subsidy• 90% report that they and their family pay for their MCHA premium• 81% report being somewhat/very satisfied with their MCHA insurance coverage 12
  13. 13. MCHA Program Use Among Enrollees• Reports of participation in health improvement programs were low, but those that used the services found them helpful Program Participation Participants that Found Program Somewhat/Very helpfulAccordantCare Disease 6% 63%management programMedica Health 7% 88%Coaching• Other programs mentioned: Health and Wellness program, MCHA’s Campaign for Healthy Living, MyMedica.com 13
  14. 14. Features of MCHA Coverage that areImportant to Enrollees80% 73% Rx coverage70% 67% 66% 62%60% Coverage for a specific Services50% Ability to see a specific provider 40%40% Cost of premium30% Ability to go to Mayo Clinic20% 18% 17% Low income subsidy10% HSA option0% Rated "Extremely Important" 14
  15. 15. Coverage for a Specific Service –Top Mentions• Annual exams, preventive services, screenings• Chiropractic services• Mental health/Chemical dependency• Mammograms• Dental and vision• Physical therapy 15
  16. 16. Reasons Enrollees Would Leave MCHA Primary Reason Can no longer afford 5% premium 5% New job with Insurance 27% offer 10% Nothing would make me leave 10% My health improves and I can get in private market Turning 65 20% 23% MCHA doesnt offer benefits I need Other 16
  17. 17. Reasons Enrollees Would Remain on MCHA Primary Reason (for those who indicated nothing would make them leave) 2% Unaware of other options 4% Other companies will not cover my pre-exiting 5% 6% conditions 31% MCHA is only coverage I can find with Mayo Other companies will not cover me 14% MCHA offers benefits other plans do not 21% Satisfied with coverage 16% Other Dont know how to change plans 17
  18. 18. Reasons Enrollees Would Remain on MCHA• Unaware of other options• Other companies will not cover my pre-existing conditions• This is the only insurance coverage I can find that includes Mayo• Other companies will not cover me• MCHA offers benefits other plans do not• Satisfied with coverage• Dont know how to change plans 18
  19. 19. MCHA Enrollees Potential Eligibility forNew Coverage Options in 2014• The majority of enrollees will likely get no federal financial support for their health insurance coverage Eligibility for Subject to MandateIncome as % FPG % MCHA Enrollees Financial SupportLess than 138% FPG 9% Medicaid Yes Premium and cost- 138-400% FPG 37% sharing subsidies through Yes the exchange Above 400% FPG 55% None Yes 19
  20. 20. Enrollee Familiarity with Health Reform100% 1% 1% 1% 5%90% 15%80% 31%70% 24%60% No answer50% 24% Very familiar Somewhat familiar40% Somewhat unfamiliar30% 59% Very unfamiliar20% 39%10% 0% General familiarity with Familiarity with potential health reform coverage changes 20
  21. 21. Enrollees Worries About Changes UnderHealth Care Reform Self Report of Worried/Very Worried % EnrolleesHaving to pay more for premiums 91%Having to pay more for deductibles and coinsurance 89%Not being able to afford the health care services you think you need 85%Not being able to afford the prescription drugs you need 78%Having to change doctors 72%The quality of health care services you receive getting worse 70%Not being able to get the health care services you need for reasons 70%other than moneyHaving to change health plans 66% 21
  22. 22. Enrollee Deductible Level by Health ReformIncome Categories Less than 138% Above 400% All Income 138-400% FPG FPG FPG LevelsPlan Deductible $500 6% 3% 4% 4% $1,000 15% 13% 17% 15% $2,000 31% 33% 30% 31% $2,700 8% 13% 17% 15% $5,000 19% 21% 20% 20% $10,000 20% 17% 12% 14%Note: deductible is from MCHA administrative data 22
  23. 23. Willingness to Enroll in a Public Program If you learned you were eligible for a public program at no cost, would you enroll? 51% 49% Yes No 23
  24. 24. Possible Outreach Methods How would you most like to receive information about coverage changes? 1% 3% 2% 2% Mail 4% Website 16% One-on-One meetings Phone number to call with questions Dont want to receive 72% information Group meetings 24
  25. 25. Key Contact Elizabeth Lukanen Senior Research Fellow elukanen@umn.edu 612.626.1537Sign up to receive our newsletter and updates at www.shadac.org @shadac

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