Insurance Outreach and Enrollment: A strategy to increase utilization and create a sustainable clinic
ABSTRACT SUMMARY
This workshop will explore how the Denver School-Based Health Centers created an Outreach and Enrollment Program to identify uninsured families and eliminate barriers to enrolling children and families into medical coverage. Presenters will share pre and post program implementation data including, utilization rates, operational expenses and return on investment, and tools and strategies used to overcome barriers to outreach methods. Presenters will also discuss how their outreach and enrollment program could be adopted and implemented in other SBHC settings.
ABSTRACT DESCRIPTION
Denver Health’s School-Based Health Centers (SBHC) are located in a large urban school district, Denver Public Schools (DPS). Over 70% of DPS students qualify for free and reduced lunch, an indicator that these children and families may be eligible for Medicaid and CHP+ (Colorado’s SCHIP program). In the era of health care reform many families have heard about the importance of having medical coverage and how it enhances the quality and continuity of patient care but there still remains uninsured children who are eligible but not enrolled. Even with the implementation of the Affordable Care Act there continues to be barriers that uninsured families face in getting children covered.
According to data in 2011, the State of Colorado had 89,246 children who were eligible but not enrolled (EBNE) in Medicaid or CHP+. Many of these EBNE children were students in DPS. Denver SBHCs has an Outreach and Enrollment Program as part of the comprehensive services that are available to families. The program is able to identify and outreach to uninsured children and families as well as assist them in overcoming barriers and obtaining medical coverage. During the 2013-14 school year, the program increased the percentage Medicaid and CHP+ visits to almost 70% which significantly decreased the number of uninsured visits in turn increasing DH SBHCs bottom line and improving the entire programs sustainability.
This workshop will discuss key strategies to establishing a successful outreach and enrollment program. Presenters will present before and after outreach and enrollment data, painting a comprehensive picture as to how the implementation of the O&E program impacted utilization and operational sustainability. Participants will discuss the barriers children and families face in getting insurance coverage and how to assist them in overcoming those barriers. The presenters will also discuss how health insurance literacy and coverage can impact the revenue that is generated within a SBHC both FQHCs and fee for service and how sustainability could be in a SBHC future.
PRESENTER(S)
NAME: Audrey Hoener MM ORGANIZATION: Denver Health School and Community Programs NAME: Ibes Madan ORGANIZATION: Denver Health School-Based Health Centers
AUDIENCE
ADMINISTRATORS: Y
PRIMARY HEALTH: Y
MENTALHEALTH: N
ORGANIZATIONAL: Y
PUBLIC HEALTH: N
EDUCATION: N
YOUTH: N
Technical
issues should be directed to Deirdre Taylor via email: dtaylor@sbh4all.org
or Telephone: (202) 638-5872, ext. 204
