Pharmacies, Not-for-Profit Groups Could Help Enroll More Californians

As director of communication and public affairs at Covered California, Oscar Hidalgo is in charge of the exchange’s marketing and outreach efforts. His job is to make millions of Californians aware of the exchange, help them understand their health insurance options and then get them to enroll.

It’s a big task with some unusual challenges. Many prospective enrollees are not proficient English speakers. They also have little contact with mainstream media. As a result, the exchange is taking a couple of non-traditional tacks to reach more people.

“Our goal is to make sure we create the proper awareness across California,” Hidalgo said. “It’s a tremendous challenge and will take multiple efforts.”

The exchange will launch a huge media advertising campaign in August. Paid employees in an “assisters” program will help individuals sign up for Covered California. The exchange will staff a telephone call-in center to help potential enrollees sign up for the right program. In addition, two other efforts go a step beyond most advertising and outreach campaigns:

  • The exchange hopes to craft relationships with big-box stores like Walmart and Costco and pharmacies such as CVS and Rite-Aid. Since many of those outlets offer postal services, tax help, banking services and eye exams, Hidalgo said, why couldn’t the exchange also have some kind of presence there?
  • Covered California has earmarked $43 million to be awarded to community groups and not-for-profit groups to set up outreach and education efforts, to raise awareness of the exchange and its insurance choices and to help people sign up for it.

At the same time, there’s work to do on the small business SHOP exchange (Small-Business Health Options Program), choices to be made on qualified health plans, the launch of a new website, and the eventual set-up of a web portal to determine eligibility and enrollment.

“I try not to think of it all at once,” Hidalgo said. “It’s very challenging. There are a lot of tasks ahead, and there are a lot of partners to solicit agreements with. We cannot do this alone. We have to get as many people as possible involved, so that we’re all helping the consumer, ultimately.”

Retail Connections Expand Exposure

The multipronged outreach and marketing approach is essential, Hidalgo said, because the exchange is starting from scratch.

“Research shows the awareness levels of the Affordable Care Act and the exchange are very low,” Hidalgo said. “They’re not well known by the general public. We are starting at a zero point, so that’s why we need to stimulate a call for action.”

He said estimates show that it could take an average of five interactions with each potential exchange enrollee to get him or her to sign up.

“Health insurance can be confusing and intimidating to individuals, and even to small businesses,” Hidalgo said. “So we need to reach out, to educate, to explain, and we need to be doing that in multiple languages.”

Covered California wants its new logo and brand to be ubiquitous, and that means placing it where people already go, Hidalgo said.

“We want to be going where people congregate,” he said. “We are looking at retail outlets, tax preparers, where people shop. A lot of retail businesses have banks, tellers, convenience businesses, and we would be there, as well.”

Carolyn Castel, vice president for corporate communications at CVS Caremark, said her organization is open to the possibilities that a working relationship presents.

“We have met preliminarily with the exchange. We anticipate working with groups like the exchange to facilitate communication around enrollment to the public,” Castel said.

Covered California’s presence in retail outlets could take a number of forms, ranging from a counter display within a store to something more event-related.

“We want our [community-group] grantees or our assisters in high-traffic areas,” Hidalgo said. “To have this exposed to the most people possible,” Hidalgo said. “You could either have an education and outreach person there, or maybe there’s a health fair or flu shot clinic, so you could have an assister enroll you on the spot. Once people are ready to act, you may need an assister where you shop to help seal the deal.”

Involving Community Groups

Trying to reach and educate large groups of people who are not proficient English speakers is the big challenge of the exchange’s outreach program. That’s why it’s so important to have community groups participate in the exchange’s business, Hidalgo said.

“The expectation is, they know that population well, and they know the channels of information they consume,” Hidalgo said. “Some people are going to need a lot more access to information, they’re just not familiar with it. And at some point they’ll need to dive in [to the enrollment process], and the grantees will offer a more local source of information and help.”

Community group leaders who know their specific population can offer information about the exchange wherever it makes sense to do that — at church functions or community events, for example.

“We want to be where people work, where they play, to use the existing infrastructures, so we can educate people at places where they already attend events or festivals, that kind of thing,” Hidalgo said. “There are influencers throughout the communities who have greater impact than we might have. And it’s good for them, as well, because it’s good to have health insurance for all populations.”

The first deadline for community groups to apply for a grant was March 4. There will be a second cycle with a deadline in late May.

According to exchange officials, the list of groups eligible to apply for grants is long: “community, consumer-focused or advocacy nonprofit organizations; faith-based organizations; trade, industry or professional associations; labor unions; chambers of commerce; health care providers; higher education institutions; tribal organizations; and city or other county government agencies.”

“We’re trying to involve as many stakeholders as we can,” Hidalgo said. “We think they can also report back, ‘Hey, this message isn’t resonating,’ that kind of thing. The thing is, we don’t have the comfort of a lot of time. We need a robust campaign that increases awareness quickly, and we need community organizations that help sustain that awareness throughout.”

At its root, it’s the quintessential grassroots campaign, Hidalgo said.

“Really what it comes down to is this: It’s communities speaking to communities.”

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