Pilot program yields scalable methods that could be applied statewide to engage uninsured New Yorkers
With the goal of addressing barriers to insurance enrollment faced by uninsured New Yorkers across the state, the Community Service Society of New York (CSS) partnered with the Health Foundation for Western & Central New York three years ago to create a network of community based organizations (CBOs) to design and implement outreach strategies to effectively reach the uninsured in their regions. The pilot program demonstrates “proof of concept” that dedicating funding for locally based marketing and tailored outreach methods yields significant enrollment gains amongst previously difficult to reach populations.
The ”Reaching the Five Percent (R5)” program, based on a report of the same name published by the Health Foundation in 2019, focused on uninsured individuals in 16 counties of Central and Western New York who were eligible for affordable health coverage but had not yet enrolled. Between 2021 and 2023, state-funded CBOs in the network leveraged their familiarity with populations in their areas to successfully connect individuals to local enrollers.
The program, which was meant to complement a broadly targeted marketing campaign by the New York State of Health Marketplace, allowed participating CBOs flexibility in their approach to reaching potential clients not typically permitted under New York State Navigator and enrollment program grants. The R5 outreach effort uses targeted messages that were specifically designed to reach groups that have been historically marginalized, such as lower-income individuals, young people, and people of color.
In this report, How to Maximize Health Insurance Enrollment: Funding Local Marketing and Outreach Innovations by Community-Based Enrollment Agencies, CSS analyzed outcomes from the pilot and the strategies deployed under the R5 model for application in other parts of the state. The results were impressive considering that the program operated during the COVID-19 Public Health Emergency when opportunities for in-person outreach were limited.
The report, co-authored by CSS’ Matt Flynn, Director of Health Insurance Enrollment Programs, Sara Santini, Program Manager for Community Health Advocates, Mia Wagner, Health Policy Manager and Elisabeth Benjamin, Vice President of Health Initiatives, discussed the following findings:
- Local marketing and outreach efforts engaged New Yorkers nine million times;
- More than 7,000 consumers were enrolled in health insurance coverage under the initiative;
- The strategy generated $9.73 in health care savings for every $1 dollar invested, a 973 percent return on investment.
“Despite the success of the Affordable Care Act in laying the foundation for the enrollment of millions of New Yorkers into health coverage, more than one million New Yorkers still remain uninsured in our state,” said David R. Jones, CSS President and CEO. “Reducing the numbers of uninsured New Yorkers while maintaining gains in enrollment numbers will require creating new approaches geared to engaging uninsured populations in their communities. This report compiles data and effective marketing activities to show a pathway to further reducing the rate of uninsured in New York State.”
“It is well understood that having health insurance is linked strongly with better health outcomes. Community Service Society’s report highlights how cross-sector collaboration, cultural responsiveness, and trusted messengers are key to improving our community’s health—in this case, by helping more people enroll in health coverage,” said Nora OBrien-Suric, PhD, President, Health Foundation for Western & Central New York. “Thank you to CSS and our nonprofit, public, and philanthropic partners for building on the knowledge of our original Reaching the Five Percent report to help a significant number of New Yorkers access their best option for health coverage.”
“Through the partnership with CSS on the Reaching the 5% project, Healthy Community Alliance was able to conduct the outreach and education necessary to identify uninsured and underinsured consumers who otherwise would not have the support needed to enroll in affordable health insurance,” Ann Battaglia, Chief Executive Officer, Healthy Community Alliance, Inc., which was one of the participating R5 community based organizations. “The funding allowed us the opportunity to try new and creative outreach methods to reach people in ways that are most convenient for them. We are proud to have been part of this project which helped close the gap in the uninsured in New York State.”
Given the success of the R5 program, state policymakers should consider supporting dedicated funding streams for local outreach because it permits agencies to create campaigns that are community-tailored and locally responsive, leading to higher enrollment numbers of consumers who have been historically harder to reach.
The Community Service Society of New York (CSS) has worked with and for New Yorkers since 1843 to promote economic opportunity and champion an equitable city and state. We power change through a strategic combination of research, services, and advocacy to make New York more livable for people facing economic insecurity. By expanding access to health care, affordable housing, employment, opportunities for individuals with conviction histories, debt assistance, and more, we make a tangible difference in the lives of millions. Join us at www.cssny.org
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