Twitter a Predictor of Insurance Exchange Enrollment

Twitter can be used as a real-time measurement of public sentiment for the Affordable Care Act (ACA) and the positivity and negativity of tweets could be used to determine state-level marketplace enrollment, according to researchers.

In a paper published in the Journal of Medical Internet Research, the authors wrote that they found a correlation between ACA-related sentiment on Twitter and enrollment of eligible individuals in a health plan chosen from an ACA insurance marketplace.

“The correlation between Twitter sentiment and the number of eligible individuals who enrolled in a marketplace plan highlights the potential for Twitter to be a real-time monitoring strategy for future enrollment periods,” first author Charlene A. Wong, MD, a Robert Wood Johnson Foundation Clinical Scholar and Fellow in Penn's Leonard Davis Institute of Health Economics, said in a statement. “This would be especially valuable for quickly identifying emerging issues and making adjustments, instead of having to wait weeks or months for that information to be released in enrollment reports, for example.”

The investigators used ACA-related tweets from March 1-31, 2014, which were selected because of their use of the terms “ACA,” “#ACA,” “Obamacare,” and “#Obamacare,” plus those directed to the Twitter handles of HealthCare.gov and the 17 state-based marketplace accounts. Overall, they collected more than 1 million tweets. They also collected a random sample of 977,000 tweets from the same timeframe to use as a comparison group.

Using the National Research Council sentiment lexicon, the researchers found a .10 increase in the sentiment of tweets corresponded with a 9% increase in health insurance marketplace enrollment at the state level.

Senior author Raina M. Merchant, MD, MSHP, director of the Penn Social Media and Health Innovation Lab and assistant professor of emergency medicine, added that they can see these findings being used to improve healthcare in real-time.

“As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape,” the authors concluded.