« March 2016 Issue

Consumer Voices for Coverage Evaluation: State Advocacy Infrastructure Diversifies its Base and Pivots its Power

A new evaluation report shows funder investments in building a consumer advocacy infrastructure have significantly strengthened the capacity of state advocacy groups to drive health coverage expansion under the Affordable Care Act. The research, conducted by Mathematica Policy Research, evaluated Consumer Voices for Coverage (CVC), a Robert Wood Johnson Foundation program managed by Community Catalyst. The findings also offer valuable insights into successful strategies that could provide a roadmap for future advocacy efforts on health and other social and economic justice issues.

Launched in 2007, Consumer Voices for Coverage was originally created to build strong consumer health advocacy networks to move health reform forward at the state level. But with the passage of the Affordable Care Act in 2010, health reform efforts moved from state to federal action. In response, CVC’s focus shifted to building state advocacy capacity to ensure consumer-friendly implementation of the ACA at the state level and then to support enrollment in health care coverage. Critical to this second phase of the program was the grantees’ ability to pivot their work to outreach, education and enrollment, and their effectiveness in making this pivot was the central focus of this evaluation.*

“A clear takeaway from the evaluation is that the investment in creating an advocacy infrastructure has helped build a strong, lasting infrastructure capable of shifting focus as new issues arise,” said Susan Sherry, deputy director of Community Catalyst. “This was not only critical to achieving the coverage expansion goals of the project, it also means advocates are equipped to apply this successful framework to future work on other health and social justice issues.”

The Mathematica evaluation examined the outcomes and activities the 18 CVC grantees reported in the final phase of the program, which included grantee work in the areas of outreach, education and enrollment to assist consumers with securing and maintaining coverage, and use of this experience and feedback from these activities to spot problems or gaps in coverage and elevate these issues with state officials to resolve them. Data sources included grant applications, phone interviews with lead staff at all 18 CVC grantees, and with 12 frontline Navigators or certified application counselors, to understand consumer problems during enrollment; and data from quarterly reports that captured activities, outcomes, accomplishments and challenges over the grant year (October 2014- September 2015). Mathematica evaluated four key areas:

Reena Singh, director of Community Catalyst’s State Consumer Health Advocacy Program, said the evaluation findings around coalition-building show that advocates successfully broadened their base of stakeholder connections to include everyone from local faith communities to LGBT groups to insurance brokers and tax preparers: “The grantees added new partners who are more racially and ethnically diverse, including deep connections within local communities, that provided critical insights into what was and wasn’t working well with regard to coverage and enrollment efforts.”

In terms of outreach, education and enrollment activities, grantees were able to point to a variety of strategies that led to coverage gains – from social media outreach and advertisements to phone banking to boost attendance at enrollment events to a radio ad featuring a local professional football player that generated 5,000 hotline calls and “the biggest spike in traffic at the state’s health insurance exchange recorded during the second open enrollment.”

The evaluation shows some of the most impactful work came from consumer feedback loops. These loops were a mechanism for regularly collecting and sharing information about consumer experiences – good and bad – around the assistance they received in learning about and enrolling in coverage, the application process, and the affordability of coverage. Advocates were charged with designing mechanisms to communicate that feedback to state and federal officials to push for course corrections.

“Each grantee was able to report at least one success in using the feedback loop to resolve an enrollment or renewal problem, which is quite significant,” said Singh. “If these organizations weren’t there doing the hard work of collecting information and consumer stories from the enrollment community and bringing it back to policymakers, these improvements wouldn’t have happened. It’s important that this work continues to be supported – it’s not done yet.”


*An earlier evaluation of the Consumer Voices for Coverage program, commissioned by the Robert Wood Johnson Foundation and conducted by Mathematica Policy Research from 2007-2011, examined the first phase of the program.

Kathy Melley, Director of Communications 

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Follow the new Center for Consumer Engagement in Health Innovation on Twitter at @CCEHI for health system transformation updates!

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Congratulations to board member Kavita Patel, MD for receiving the 2016 Cancer Center Innovator Award at the Cancer Center Business Summit.

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Katherine Howitt, associate director of policy, was featured on the Healthcare Finances Management Association website after Louisiana passed legislation to close the coverage gap.

We’re excited to announce that Cindy Mann, formerly the top Medicaid official in the Obama Administration, has joined Community Catalyst and the Center for Consumer Engagement in Health Innovation as a strategic advisor. 

We also welcoming Bob Master, MD, founder and former chief executive officer of the Commonwealth Care Alliance, as a senior fellow at the Center for Consumer Engagement in Health Innovation.

Join us in welcoming new staff members: Ilene Weismehl, Database and CRM Manager; Kris Wiitala, Program Associate; Jennifer Lemmerman, associate director, External Affairs; Also, congratulations are in order for Tera Bianchi, who was promoted to Dental Access Program project director.

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