Is Your Outreach Missing Essential Groups?

As time approaches another Open Enrollment for the Healthcare Exchange, hospitals are reminded of the many people still uninsured who, even though they are eligible, are not utilizing the Healthcare Exchange.

Who is still uninsured?
Statistics show that 15 million men are uninsured in this country, half of which were non-elderly adults. Nearly a third of those uninsured reported having trouble paying medical bills and 4 out of 10 uninsured men are now eligible to receive coverage through the ACA Healthcare Exchange. So why is this group not participating in the Healthcare Exchange? Researchers have polled this population and have found them to be skeptical about engaging with government programs due to lack of information about availability, the perceived difficulty of the application process and exclusion to Medicaid prior to the ACA expansion in some states.

Another significant demographic that is not participating in the Healthcare Exchange are those aging off other insurance options such as Medicaid or their parent’s insurance plans. According to reports, only half of these young adults leaving their parent’s plan are buying insurance for themselves through the Exchange. This is likely due to the high insurance premiums offered by the plans.

As a hospital, what can you do to successfully reach those people and increase participation?
You and your local CAC’s or Navigator Organization can begin outreach efforts in community locations such as college campuses, churches, barber shops, extension centers and libraries. In addition, organizations can also reach out to small business organizations and job placement centers to have information available to the people they assist. In a concerted effort to reach the younger population, hospitals can join in the outreach that has begun via email and partnerships with companies that are widely used by the younger population such as Lyft and Uber.

Why is targeting these groups critical to you as a healthcare organization?
Because 68% of the eligible people in these groups have very few health risks, their participation in the healthcare exchange by obtaining insurance decreases the risk pool, thus decreasing the cost of healthcare.


Kary Wallace, Director of Training and Compliance