CHIPRA Cycle II Grantees: Successful Strategies to Enroll Eligible Children in Medicaid and CHIP

1. CHIPRA Cycle II Grantees: Successful Strategies to Enroll Eligible Children in Medicaid and CHIP

2. MPCA CHIPRA Cycle 2Coverage Retention Program Stopping the Leak Phillip J. Bergquist, CHCEF Manager of Health Center Operations CHIPRA Project Director www.mpca.net

3. About MPCA • MPCA is a statewide nonprofit organization working to promote, support, and develop comprehensive, accessible, and affordable community-based health care services to everyone in Michigan. • MPCA represents 32 Michigan Community Health Centers which are the health care home for nearly 600,000 patients annually at over 190 sites across the state. • MPCA was a CMS CHIPRA Cycle 1 grantee in addition to our current Cycle 2 program.

4. Background Nationally, “More than a quarter of all uninsured children in 2008 had been enrolled in Medicaid or CHIP the year before. In other words, roughly two million children became uninsured in 2008, despite their ongoing eligibility for these programs.” In Michigan, 44% of the currently eligible but uninsured children dropped out of Medicaid or CHIP during the previous year. Data shows retention across the country is improving, but not quickly enough.

5. What We’re Doing • MPCA’s program, in partnership with 8 Michigan Health Centers, works with a population of 90,000 Medicaid/CHIP enrolled children to: • Ensure families understands how and when to reapply for coverage. • Remind the family to reapply as their renewal date approaches. • Offer assistance with redetermination over-the-phone and in-person through their community-based Health Center providers.

6. How It Works • Parents of Medicaid/CHIP enrolled children receive both a voice and text message in the 11th month of coverage. • In the 11th month, parents can press a button on their phone when they receive the voice message or reply to the text message to receive renewal assistance over-the-phone. • Parents receive a voice message in the 12th month of coverage. • In the 12th month, parents can call to schedule an appointment (or walk-in at some Centers) to receive renewal assistance in-person at their local Health Center.

7. Voice Messaging Results Nearly 70% of Messages Were Successful on the First Try - Less Than 6% of Phone Numbers Were Invalid - Roughly 3.5% Requested Assistance Directly - Less Than 1% of Parents Opted-Out 20% of Messages Need To Be Re-Sent Data from 5,000 recent voice broadcast messages selected at random.

8. Text Messaging Results • The system screens out all duplicate numbers (23-66%) before texts are sent • Almost 100% of the texts were sent successfully • Less than 1% of parents opted-out • Less than 2% of numbers were invalid Data from 3,000 recent text messages selected at random.

9. Client Education Results • Providing supportive “education” with enrollment assistance helps clients understand the coverage system including renewal Data from client feedback surveys post initial enrollment with 11% response rate.

10. Lessons Learned (So Far…) Getting the data is no small task, it took nearly 5 months to get permission, pull, format and match Knowledge of HIPAA and other applicable privacy/security is crucial Using a combined, online system for both text and voice messages has been very convenient and helps maintain Do Not Call lists and screen duplicate numbers There’s a big learning curve amongst enrollment assisters on the redetermination process An online renewal application makes the process much easier for everyone involved We should have incorporated renewal reminders (with client permission) in our enrollment program from the beginning It’s a lot easier (and cheaper) than it seems!

11. Questions? For further information, please contact: Phillip J. Bergquist 517-827-0473 pbergquist@mpca.net www.mpca.net

12. Using phonathons to enroll uninsured children on Medicaid Deanna White CHIPRA project manager & Coordinator of the SW Ohio Covering Kids & Families coalition Legal Aid Society of Southwest Ohio LLC dwhite@lascinti.org (513) 362-2760

13. Why have a phonathon • Gives people a chance to call from the convenience & privacy of their homes. • Provides families with an expert who can answer their questions right then. • Offers callers friendly assistance with the Medicaid application process from start to finish.

14. The basics of organizing a phonathon

15. Outline of our 12/7/11 phonathon

16. Results • Lesson learned: • We can spend far less in advertising, spend more time in following up with folks that call us, and net very similar enrollment results.

17. More lessons learned: It doesn’t have to be giant & complicated to be effective. Nobody calls during the morning news hour. Start at 9am or later. Having poorly trained/inexperienced volunteers can cause lots more work on the back end. Don’t front load a bunch of information about the application process with the families. Keep track of lessons learned. The messaging from our friends at GMMB & Lake Research Partners works.

18. Messages that work… A family of four can earn $44,000 a year or more and their uninsured children can still qualify for CHIP and Medicaid. In these tough economic times, when so many people have lost their jobs and families are struggling to make ends meet, Medicaid can help cover the cost of health care for kids and teens, even if it’s temporary. ……so parents don’t have to choose between paying for groceries or paying for health coverage. These programs provide low-cost or free health coverage for important health services such as doctor visits, hospitalizations, check-ups, dental and vision care, immunizations, mental health, prescriptions and more. If your situation has recently changed and your child needs health insurance, call us today.

19. How can this method be useful as we look ahead to 2014 ACA changes • We’ve developed a partnership with a local media outlet  we can use that to get information out to the public in 2014. • We have a loyal troop of volunteers that we know how to mobilize & train quickly. • We’ve learned how to prep testimonials for television, which we may be something we can replicate in 2014.

20. Eligibility Assistance Unit

21. Our Purpose The Eligibility Assistance Unit at Miami Children’s Hospital takes pride in helping our patients and assisting our community. Our team is responsible for financially clearing 100% of the children who have services rendered at our hospital and specializes in screening for Medicaid and Florida KidCare.

22. Screening Process ***Note: Until patient is not Medically Cleared by a physician, EAU does not approach guarantor for insurance information.

24. Medicaid Applications Florida KidCare Applications • Keys to Our Success • 24/7 Staff • Bi-Lingual/ Tri-Lingual Employee’s • Follow-Up • Phone Assistance • Reporting • What makes our team?? • Empathy- We recognize and to some extent share our patients feelings. • Passion- Our passion for what we do, reflects on the work we provide. • Compassion- We have a strong desire to alleviate suffering. • “We are, where the children are!”

25. 2014 Our Team’s success is driven by the determination our staff has to positively impact and help out our entire community. In order to find the best option for continuation of care, 100% of our families are systemically already thoroughly screened for health care coverage. What 2014 will mean to Miami Children’s Hospital is OUTREACH. We will target communities in need and use processes that are already in place, to obtain eligibility for everyone in the family for the additional coverage options such as Medicaid expansion and health exchange.

26. Contact Us Esther Gonzalez Soraya Ortega Eligibility Assistance Unit Manager Eligibility Assistance Unit Supervisor Miami Children’s Hospital Miami Children’s Hospital 305-666-6511, Ext. 2929 305-669-6525 esther.gonzalez@mch.comsoraya.ortega@mch.com Jodi Ray Avery Slyker Program Director Program Manager Florida Covering Kids & Families Florida Covering Kids & Families 813-974-3143 813-974-8272 jray@health.usf.edu arosnick@health.usf.ed Melanie Hall Florida Association of Children’s Hospitals Director of Florida KidCare Outreach 813-428-4653 melanie.mshconsulting@gmail.com