Health Care for All-Massachusetts is strongly committed to outreach efforts across the state. As outreach workers, we often hear the question: “What strategy or activity is the most effective in enrolling folks in coverage?” The answer is: everything, all the time. Simply put, there is no magic bullet. If there is one lesson Massachusetts learned from its 2006 state health care reform, it is that outreach must be consistent and continuous. It is essential to create multiple pathways for people to get information and to do so consistently throughout the year, rather than focusing on one pathway or event or one period of time. Enrolling consumers in coverage requires an ongoing effort to help people enroll, re-enroll and renew coverage as people’s circumstances change and new people move to the state.

Some of our greatest challenges in doing this work have been to clearly show the important role of consumer assistance, and ensure that we are continuously improving and refining our efforts to reach more consumers. We have addressed these challenges by developing a system for evaluating our work.

The idea of evaluation can often be overwhelming and intimidating due to the perception that it requires a deep set of quantitative skills. This is not the case – in reality, evaluation is finding out what works and what does not in an effort to make us better at what we do and meet the changing needs of consumers. Over time, this will make us more efficient and will showcase our effectiveness. This past year, HCFA took a couple of different approaches to evaluation that are integrated into our routine work and that provide us with rich data about how to do our jobs better.

Integrating tracking tools into our work.

One basic approach to evaluation is tracking—for instance, counting the number of brochures or materials that get distributed at outreach events. While knowing distribution numbers is a good first step, the gold standard,  is being able to tie outreach activities directly to enrollment numbers, which brochure counts cannot do. At Health Care For All, we make this connection through collecting key pieces of information when working with consumers who call our HelpLine, which provides over-the-phone assistance to health care consumers. We are able to analyze the data collected from our clients to highlight successes and point out areas for improvement in our outreach strategy.

We begin tracking data as soon as a consumer calls our HelpLine, starting with asking how they heard about us. We keep a tally of what outreach strategy got us the highest volume of calls, from handing out brochures at educational events to partner referrals to advertisements in various media outlets. In many cases the caller has heard about us from a number of sources and is unable to pinpoint which source drove them to call. However, through asking consumers where they heard about us, we learned that consumers need to see or hear our message an average of seven times to take action, indicating that bombarding consumers with the information they need tends to be successful. We are also able to use this data to geographically tie outreach activities with enrollment by comparing where we have focused our outreach efforts with enrollment numbers.

Adapting to lessons learned as we go.

We view evaluation as a dynamic tool that allows us to make changes as we go  to improve the effectiveness of our work. Our tracking work this past year has done exactly this. For example, we were able to determine that advertising through a radio outlet was more effective than a newspaper in one particular community. The radio shows generated dozens of calls every time we did a live interview with a particular host who is a well-known community organizer versus one call after one newspaper ad. Once we recognized this, we chose to stop spending on newspaper ads and re-direct those funds to more effective media outlets.

At Health Care For All, we know that outreach is an important part of getting people covered and keeping the insurance rate in Massachusetts one of the highest in the nation. Evaluation has helped us sustain our outreach efforts and make them as effective as possible. Ongoing evaluation is a critical piece in the coverage puzzle and in making sure that everyone in the Commonwealth has access to high quality, affordable, culturally competent health care.  

Maria Gonzalez Albuixech, Director of Communications and Marketing, Health Care For All,
and Gabrielle Orbaek White, State Advocacy Manager, Community Catalyst