Industry consultant Rosemarie Day, founder and president of Day Health Strategies LLC, notes that the Trump administration is not only decreasing ACA exchange navigators’ funding — but as of Sept. 12 apparently hadn’t completed contracts for organizations still being funded.
“I don’t know that insurers can make up the difference, but there are things they can do,” says Day, who was founding deputy director and chief operating officer of the Massachusetts Health Connector, a state-based model for ACA exchanges.
The “low-hanging fruit” for plans is retaining current enrollees, because there is significant turnover in the individual market, Day says.
Also important is plans’ outreach to the newly uninsured, “and this is where insurers have to get creative,” Day says. “It’s hard for me to know the ROI [return on investment] on this, but insurers could do blanket advertising for open enrollment with a message that might capture folks who don’t need to go to the exchange,” thus leveraging spending in other areas of their business.
Day explains that the idea is for the plan to build on what it is doing for related markets to send out messaging more broadly and disseminate information cost effectively. This might involve combining messaging to individuals and small businesses — or perhaps the individual market and Medicare.
Moreover, she says, plans ought to consider teaming up with pro-ACA groups like Indivisible that are trying to get the word out on exchange enrollment through social media — or at least be aware of what such groups are doing. She says insurers also might try to get local media coverage on their efforts, thus perhaps getting out the message free of charge about exchange enrollment.
If plans opt to stay in exchanges for 2018 amid exits, Day says, “From the insurers’ perspective, they should play it to the hilt: ‘We’re here for you.’ Very positive.”
“I don’t want to suggest this will make up for the loss of [marketing and outreach] funding at the federal level” or lost navigator money, Day says, adding that insurers with Medicaid experience likely have more expertise and ability to make up for some of the navigators’ shortfall.
Broadly speaking, “[I]nsurers have to think about every marketing channel they’ve got and think about leveraging them,” she says. Also, given the shorter open enrollment period for federally facilitated exchanges this fall, plans should be “making it clear, getting rid of the noise about the [marketplace] uncertainty and creating urgency around the earlier deadline,” she says.
Down the road, absent sufficient federal money for marketing and outreach, plans may have to build in some advertising money into their rates, she says. “We may be recalibrating here for a ‘new normal.’”
As for this fall, Day says, “I think it’s tough right now because we don’t know what’s happening with CSRs and what will happen with insurers’ rates. But that shouldn’t hold up advertising.”
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