Hospitals get tips for enrolling uninsured in California exchange

The California Hospital Association (CHA) has released a new guidebook that enables hospitals to enroll uninsured patients in the state's health insurance exchange, Covered California, which will begin taking consumer applications Oct. 1.

Many of the uninsured patients that California hospitals treat will be eligible for subsidies to obtain coverage through the new online marketplace, but Covered California estimates that up to 75 percent of these individuals may need enrollment assistance. As such, the CHA wanted to create a step-by-step process that hospitals can take to determine their eligibility.

"Enrolling the uninsured in health coverage programs will be a massive undertaking, and California's hospitals will play a major role," Anne McLeod, CHA senior vice president of health policy, said in a statement. "The CHA guidebook provides hospitals with the information and strategies necessary to achieve this goal."

The manual lays out eight specific strategies--designing enrollment procedures, optimizing staffing and support, educating patients, positioning staff, reaching vulnerable populations, partnering with external stakeholders, partnering with service vendors and assessing the new environment--based on interviews with key hospital management and supervisory staff. The employees work at a wide range of California hospitals, including community hospitals, safety-net hospitals as well as multi-hospital and multi-state systems.

To design enrollment procedures, for example, the guidebook identifies various information and ideas on eligibility screening and verification that are transparent and supported by effective tools. Educating patients is another strategy the CHA details in the guidebook, explaining that hospital eligibility and enrollment staff should create partnership-like relationships with patients to establish trust and engagement.

The CHA also suggests that hospitals consider placing employees in typical access points for the uninsured, including inpatient admitting areas, emergency departments, pharmacies, laboratories, women's clinics and outpatient sites. That way enrollment staff can build strong relationships with uninsured patients. "Using highly trained personnel at strategically identified sites ensures that the hospitals reach the greatest number of individuals requiring coverage eligibility and enrollment assistance," the CHA said.

The guidebook also offers steps for reaching out to vulnerable populations, such as people who are homeless or have a mental illness. The CHA recommends hospitals build upon their "already strong practices" of placing enrollment staff at critical locations where these uninsured patients typically access care.

To learn more:
- read the CHA statement