Many consumers who sign up for an exchange plan have post-enrollment questions, especially those new enrollees who went uninsured for a period of time.
"Enrollment is like a pre-step," Sarah Davis, associate director of the Center for Patient Partnerships at the University of Wisconsin-Madison, told Politico. "Having insurance isn't the goal, having insurance is the precursor to effectively utilizing health insurance, to accessing care. The goal is the care, and there are roadblocks along the way."
Newly enrolled members need help, for example, understanding insurance jargon like deductible, copayment and coinsurance. They also often need to learn how to locate a primary care physician and what they should do if their doctor is out-of-network.
Outreach and education is vital because industry experts fear new members might not seek care or renew their health plan if they encounter problems and have no assistance to resolve the issues.
To help its new members become active healthcare users instead of only policyholders, Humana has implemented an innovative approach in Mississippi. After obtaining approval from the Centers for Medicare & Medicaid Services, it now waives fees for its newly enrolled members who see a doctor for a nonpreventive visit before June, according to another Politico article.
"As you may know, Mississippi has some of the nation's highest healthcare costs because of the comparative unhealthiness of the state's population (i.e., obesity, diabetes, other chronic health conditions), and historically Mississippians have not had widespread access to affordable, quality healthcare," Humana spokesman Mitch Lubitz told the newspaper.
State Insurance Commissioner Mike Chaney said Humana's financial carrot is an "effective" tool that already has fueled an enrollment surge.
To learn more:
- read the Politico article about post-enrollment
- see the Politico article about Humana
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