Enrolling Consumers Not Enough-They Need to Be Engaged, Too

Increasing health insurance enrollment is only one part of the goal of the Affordable Care Act (ACA)—the law also aims to improve population health and lower healthcare costs, but less attention has been paid to these critical steps, according to a new analysis from RAND.

Researchers conducted phone interviews with stakeholders in Connecticut, Kentucky, Texas, and Washington and the analysis describes lessons learned from these conversations.

“We know millions of previously uninsured people have been enrolled into insurance plans,” Laurie Martin, lead author of the report and a senior policy researcher at RAND, said in a statement. “Achieving the long-term goals of the Affordable Care Act related to improved population health and lower health care costs are going to require more work.”

The conversations revealed 4 critical phrases of engagement: 1) applying for coverage and selecting a plan; 2) gaining coverage and understanding plan benefits; 3) finding a provider and accessing care; and 4) engaging in care over time. The first phase was completed during the first 2 open enrollment periods under the ACA, when there was mass outreach for enrollment in the health insurance marketplaces.

Low health literacy continues to be a barrier as consumers struggle with health insurance terminology such as co-pays, coinsurance, deductible, in network, and out of network.