Personalized Telephone Outreach Increased Health Insurance Take-Up For Hard-To-Reach Populations, But Challenges...

Area of Science:

• Health Services Research
• Public Health Policy
• Behavioral Economics

Background:

• The Affordable Care Act Marketplace aims to increase health insurance coverage.
• Effective outreach strategies are crucial for maximizing enrollment, especially among vulnerable populations.
• Understanding the impact of personalized interventions can inform policy and program design.

Purpose of the Study:

• To evaluate the effectiveness of personalized telephone calls from service representatives on health plan enrollment.
• To identify subgroups that benefit most from such outreach interventions.
• To assess the return on investment of this enrollment assistance strategy.

Main Methods:

• A randomized controlled trial was conducted with 79,522 consumers in California who had applied but not selected a health plan.
• Participants were assigned to either receive a personalized telephone call or not.
• Enrollment rates were compared between the intervention and control groups.

Main Results:

• Personalized calls increased overall health plan enrollment by 2.7 percentage points (22.5% increase).
• Significant enrollment increases were observed among low-income individuals, those referred from Medicaid, older adults, Hispanic individuals, and Spanish or English preferred language speakers.
• The intervention yielded a two-to-one return on investment.

Conclusions:

• Personalized telephone outreach is an effective strategy for increasing health plan enrollment in the Affordable Care Act Marketplace.
• Targeted outreach can effectively reach and enroll specific high-need populations.
• While effective, persistent enrollment barriers may limit the overall impact, necessitating further policy considerations informed by the American Rescue Plan Act of 2021.