Transcript MPCA CHIPRA Cycle 2 Coverage Retention Program

CHIPRA Cycle II Grantees: Successful
Strategies to Enroll Eligible Children in
Medicaid and CHIP
MPCA CHIPRA Cycle 2
Coverage Retention Program
Stopping the Leak
Phillip J. Bergquist, CHCEF
Manager of Health Center Operations
CHIPRA Project Director
www.mpca.net
About MPCA
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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.
Background
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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.
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:
1. Ensure families understands how and when to
reapply for coverage.
2. Remind the family to reapply as their renewal
date approaches.
3. Offer assistance with redetermination over-thephone and in-person through their communitybased Health Center providers.
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.
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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.
Voice Messaging Results
45.0%
40.0%
Nearly 70% of Messages Were
Successful on the First Try
40.0%
- Less Than 6% of Phone Numbers Were Invalid
35.0%
- Roughly 3.5% Requested Assistance Directly
29.0%
30.0%
- Less Than 1% of Parents Opted-Out
25.0%
20.5%
20.0%
20% of Messages Need
To Be Re-Sent
15.0%
10.0%
5.3%
5.0%
3.4%
0.7%
0.5%
DNC
Busy
0.8%
0.0%
Live
Machine
No Ans
Transfer
Error
Data from 5,000 recent voice broadcast messages selected at random.
Misc
Text Messaging Results
100.0%
99.9%
- The system screens out all duplicate
numbers (23-66%) before texts are sent
90.0%
- Almost 100% of the texts were sent
successfully
80.0%
70.0%
- Less than 1% of parents opted-out
60.0%
- Less than 2% of numbers were invalid
50.0%
40.0%
30.0%
20.0%
10.0%
0.1%
0.0%
Succescful
DNC
Data from 3,000 recent text messages selected at random.
Client Education Results
- Providing supportive “education” with enrollment
assistance helps clients understand the coverage
system including renewal
100.0%
95.0%
93.7%
92.2%
90.0%
85.0%
82.4%
80.0%
75.0%
70.0%
65.0%
60.0%
55.0%
50.0%
Understand Services
Who to Ask Questions
Understand Renewal
Data from client feedback surveys post initial enrollment with 11% response rate.
Lessons Learned (So Far…)
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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!
Questions?
For further information, please contact:
Phillip J. Bergquist
517-827-0473
[email protected]
www.mpca.net
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
[email protected] (513) 362-2760
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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.
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The basics of organizing a
phonathon
Partner with a local TV station.
Most stations are set up to
accommodate telethons.
Develop a budget and buy
advertising.
Our partner station has a theme of
“9 on your Kids Side”.
Our 12/11 phonathon had a $2500
budget – paid for by a Medicaid
Managed Care Plan.
Buy advertising & ask for in-kind.
Recruit & train volunteers.
Our volunteers are CKF coalition
members and grad students in
medicine & social work.
All volunteers are trained on a script
and how to complete a Medicaid
application.
Recruit a family from a past
phonathon to do a testimonial to air
during the phonathon.
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Outline of our 12/7/11 phonathon
12 phones
Lines open from
5 shifts/12 per shift =
60 volunteers
9am – 9pm
Cuts to CHIPRA staff for
live interviews during
news hours + live interview
with a family during 6pm
news
19 paid spots that aired
throughout the 12
hours
Crawl ran at bottom of
screen all day with our
phone number
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Results
Budget
# of
calls
# of
kid
calls
# of
applications
returned
Rate of
return
# of kids
enrolled
# of applications
pending
12/7/11
phonathon
$2,500
365
250
127
50.80%
85
49 apps = 74 kids
4/20/11
phonathon
$14,000
(+ 33 parents)
656
411
142
34.55%
158
--
(+32 parents)
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.
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More lessons learned:
1.It doesn’t have to be giant & complicated to be
effective.
2.Nobody calls during the morning news hour. Start at
9am or later.
3.Having poorly trained/inexperienced volunteers can
cause lots more work on the back end.
4.Don’t front load a bunch of information about the
application process with the families.
5.Keep track of lessons learned.
6.The messaging from our friends at GMMB & Lake
Research Partners works.
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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.
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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.
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Eligibility Assistance Unit
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.
Screening Process
Patient Arrival
Patient arrives
through
Emergency
Department
Verification
Insurance is
verified by using
Basic Patient
Identifiers already
on file.
Agency for Health
Care Administration
(AHCA)
AHCA’s on-line
computer system
is checked to
confirm that the
patient does not
have Medicaid
coverage or an
application
pending with the
Department of
Children &
Families (DCF).
Uninsured
If patient is
identified as
“uninsured”, a
financial
evaluation and
Medicaid
application are
completed.
Share of Cost
Medicaid
If the patient is
enrolled in
Medicaid Share of
Cost, a financial
evaluation is
completed and
guarantor is
assisted with
Florida KidCare
Application.
***Note: Until patient is not Medically Cleared by a physician, EAU does not approach guarantor for insurance information.
• Applications stored
by date of
application.
• All patients with a
case pending at
local DCF are filed
under Back-Up.
• Florida KidCare
applications are filed
separately by month
and date.
Productivity
Logs
Accountability
=
Success
Missing Report
Medicaid
Status
Report
Back –Up Applications
Tracking System
Phone Calls
• Phone-Calls are made to
each account on a weekly
basis.
• Expected compliance
date noted on each
account.
• Detailed voice message
is left regarding pending
documents.
• All numbers listed on
application and provided
to registration are called.
• Are checked twice a
week in AHCA online system and with
DCF Representative.
• Phone call is made
to parents requesting
them to comply with
DCF request for
application
information.
Medicaid Applications
Florida KidCare Applications
Keys to Our Success
24/7 Staff
Bi-Lingual/ Tri-Lingual Employee’s
Follow-Up
Phone Assistance
Reporting Empathy- We recognize and to some extent share our
What makes our team??
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!”
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.
Contact Us
Esther Gonzalez
Eligibility Assistance Unit Manager
Miami Children’s Hospital
305-666-6511, Ext. 2929
[email protected]
Soraya Ortega
Eligibility Assistance Unit Supervisor
Miami Children’s Hospital
305-669-6525
[email protected]
Jodi Ray
Program Director
Florida Covering Kids & Families
813-974-3143
[email protected]
Avery Slyker
Program Manager
Florida Covering Kids & Families
813-974-8272
[email protected]
Melanie Hall
Florida Association of Children’s Hospitals
Director of Florida KidCare Outreach
813-428-4653
[email protected]