Evaluating the Effect of Automatic Plan Assignment and Enhanced Outreach of Marketplace Take-up
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Informational flyer, Modified eligibility notice with plan information.
- Who it may be relevant to
- Registry conditions: Outreach Intervention. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Facilitated enrollment offers a potential solution to some administrative burdens and choice frictions that may produce incomplete take-up of marketplace coverage. Because Covered California, California's ACA individual marketplace, and Medi-Cal, California's Medicaid program, share an eligibility system, Covered California has the ability to identify individuals who are eligible for marketplace coverage upon losing Medicaid eligibility. This evaluation will compare the effectiveness of facilitated enrollment strategies, including personalized plan pre-selection and personalized quotes of net premiums, to other enhanced, but general outreach tactics, on marketplace take-up among individuals losing Medi-Cal coverage.
Interventions
- Behavioral Informational flyer
In addition to a standard eligibility notice informing participants of their eligibility for marketplace coverage, they receive an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays - Behavioral Modified eligibility notice with plan information
a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount in addition to the informational flyer and instead of a standard eligibility notice
Primary outcome measures
- Enrollment [Time frame: within calendar year since the loss of Medicaid]
Secondary outcome measures (8)
- Tenure [Time frame: within 1-2 years after treatment assignment]
- Uninsured [Time frame: within 1-2 years from the treatment assignment]
- Consumer engagement [Time frame: within 90 days from the treatment assignment]
- Office visit [Time frame: during 1-2 years since the treatment assignment]
- Prescription filled [Time frame: during 1-2 years since the treatment assignment]
- Emergency room visit [Time frame: during 1-2 years since the treatment assignment]
- Hospital admission [Time frame: 1-2 years before and during 1-2 years after the treatment assignment]
- Out-of-pocket health care spending [Time frame: during 1-2 years since the treatment assignment]
Eligibility criteria
Inclusion criteria
- Individual in a single-member household
- Discontinued from Medi-Cal
- Eligible for Covered California program
- Ineligible for APTCs on initial application
- Did not attest to planning to file taxes within their Covered California application
Exclusion criteria
- Consumer case is no longer active within the application system
- Consumer is already actively enrolled in a marketplace plan
- Consumer has already restored Medi-Cal eligibility
- A consumer's Special Enrollment Period has ended
- Consumer is no longer listed as a single-member household
- Consumer was procedurally denied from Medi-Cal coverage due to no response
- Consumers has a MAGI Medi-Cal income less than 138% of the Federal Poverty Level (FPL)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Health services research
Study locations
United States · 1 center
- Covered California — Sacramento
Identifiers
NCT: NCT06709794 · CCA-MAPS-2024