Connecticut Health Exchange Refocuses Efforts On Outreach, Education

"Fine, you're enrolled. Now what?" That is the question that Andrea Ravitz, director of marketing at the state's health insurance exchange Access Health CT, says the organization will be seeking to address over the next three years.

With statewide enrollment at over 116,000 as of the end of March, AHCT will now increasingly strive to educate consumers on how to derive maximum benefits from their selected insurance plans.

"Our first years were about making sure people were getting enrolled and avoiding penalties," Ravitz said. "Now we are addressing the feet that members are coming in with no idea of what to do with their plans and benefits. The problems are very similar to those with health insurance outside the AHCT - it can be a complicated, sometimes intimidating process to pick one plan over another... and not just the plan, but the company. There's a lot of hand-holding involved."

This shift in focus is being led by AHCT CEO Jim Wadleigh, who has noted that the exchange, created in 2012 as part of the Affordable Care Act, has as its mandate not only insuring Connecticut residents but also improving the quality of health care provided. Nevertheless, his move has ruffled a few feathers.

During an AHCT board meeting in April, Benjamin Barnes, secretary of the state Office of Policy and Management and a board member, told Wadleigh that he felt that, given the "tens of thousands" of residents still uninsured, the time may not yet be right to move away from enrollment efforts. Wadleigh replied that many of the remaining uninsured are illegal immigrants and thus ineligible for exchange coverage.

"I strongly support Access Health's work to improve the health of its enrollees, and I also believe that we need to remain committed to reducing the number of uninsured Connecticut residents," Barnes reiterated recently. "There is no conflict between these goals, and I have great confidence that we will continue to make progress toward them."

At the board meeting, Wadleigh was also taken to task for not working more closely with the state Department of Social Services (DSS), which is the administering agency for Medicaid; some 200,000 people are covered by Medicaid under the ACA.

DSS commissioner Roderick L. Bremby indicated that that situation is already improving. "Expanded work by Access Health in health care outcomes and related areas will dovetail nicely with the quality innovations DSS has been building into the Medicaid program over the past several years," he said. "Overall, Connecticut is already a national leader, if not the national leader, in successful implementation of the Affordable Care Act, thanks to the strong leadership by the Malloy-Wyman administration. We look forward to further advances over the coming year."

As for AHCT, it is embarking upon a year-round community outreach program by partnering with Grossman Heinz, a public affairs firm specializing in government relations, grassroots mobilization, and lobbying.

"We want to make sure that we're out in the community talking with leaders and influences," Ravitz said, "to help spread the word about what's available and what they might already have."

To that end, Grossman is currently seeking project, events, and outreach coordinators to handle the planning and logistics of AHCT's presence at fairs, festivals, farmers' markets, AHCT-sponsored forums, and other community events.

Ravitz noted that that outreach will also address language barriers. Although all of AHCT's materials are available in Spanish, she said, there are obviously dozens of other languages that residents primarily speak.

"There are also a lot of dialects that simply translating our printed materials in another language doesn't necessarily address," she added. "We want to explain our message to community leaders and influences, who can then deliver that message in their own cultural ways to their peers."

The organization is in the process of rolling out a number of consumer tools on its website, accesshealthct.com. Included is a feature where a consumer inputs some basic information on the current state of their health, family, location, income, etc., after which the system responds with suggestions of the best options for them.

"When they first enroll, most people pick the plan and company based on price," Ravitz noted, "but this takes it a little bit further. Some may have chosen the bronze plan during the first year, but when they go to the doctor they have to pay a little more for that visit. That may be okay for someone who's in good health, but may not be the best way to go for those who need to make several visits throughout the year."

She said the exchange is using an expanding array of internal and external data analytics to "see where we need to advance and stretch ourselves in the best way possible."

AHCT admits that it still has much work to do in reaching minorities; according to the latest U.S. Census Bureau data, as of July 1, 2014,15 percent of Connecticut's population is Hispanic/Latino, followed by AfricanAmericans (11.5 percent) and Asians (4.5 percent). "There are a lot of little percentages after those," Ravitz said. "But they are there, and we need to address them."

In another recent development, AHCT representatives have begun attending naturalization ceremonies held for newly naturalized immigrants at the U.S. District Court in Hartford to provide information about health care plan options available to them and their families. AHCT is the only state-based exchange currently involved in such efforts.

"That's one of the first projects I got involved with when I joined AHCT in 2013," Ravitz said. "We address them about 45 minutes before the judge enters the courtroom. Educating new citizens and their families who are either seeking residency or citizenship, or who are applying for visas to work or study here, is very important. The majority of them don't know that they can get better insurance, and can apply as long as they're legally present."

She said that AHCT hopes to expand its presence at such ceremonies at the U.S. District Courts in New Haven and Bridgeport as well, with the ultimate "home run" goal of including AHCT literature in Immigration and Naturalization Service mailings - "which everybody opens."

Ravitz also addressed the recent announcement by United Healthcare that it will exit the exchange at the end of the year. "We are working to address with those members who have United that it will no longer be a part of the exchange, and explaining their options," she said.

According to healthcare.gov, United had 2 percent of the exchange market share in 2015, which dropped to 1.3 percent this year. ConnectiCare currently has about 53 percent of exchange enrollees, followed by Anthem at 33 percent and Healthy CT, also known as The Co-op, at just under 12 percent.