Outreach workers do the hard work of explaining policy changes to real people, so often they are among the first to hear feedback about how they are working. Not surprisingly, this was a theme of the Western Mass. Health Access Network meeting this February, when we gathered with outreach and enrollment workers from Berkshire, Franklin, Hampshire and Hampden counties. HAN members doing enrollment agreed that there is still confusion and frustration in their communities.
The good news is that people keep coming to them and that screening sessions are excellent opportunities for education. The bad news is that people continue to be frustrated by the lack of affordable options and by the mandate generally. One group in particular was highlighted - older individuals who move from eligibility for Commonwealth Care to Commonwealth Choice because of a small increase in income. They can face big increases in monthly premiums.
This month's unexpected 'red flag' issue was copays. Turns out that some people with chronic conditions - cardiac rehab, epilepsy - sometimes require hospital treatments several times a week. Each visit could have a $25 co-pay, meaning people have out-of-pocket expenses totaling $75 a week - that's $300 a month, on top of premiums, for someone who makes around $600 a month. Outreach workers are seeing clients cutting back on their treatments.
'Churn' was the special topic this month. Rich Grief of Network Health described it as the disenrollment and subsequent re-enrollment of people who are really still eligible for either MassHealth or CommCare. Network Health data show that of 50,000 people they had to disenroll last year, 60% returned in less than 90 days. The most common reason for disenrollment? Mail being returned because of incorrect addresses.
Rich and Boston Medical Center HealthNet's Eric Goldstein agreed that the best way to prevent churn is for people is to have updated addresses on file with the state. But even though health plans and outreach workers try to find every opportunity to collect corrected addresses, only the state can change the official record. The reduction of the re-determination filing period from 60 to 45 days makes updating the records in time even more challenging.
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