Expanding coverage in rural communities means meeting uninsured residents where they live
By Shellie Byrum
To reach people who need health coverage in isolated areas, you have to meet them where they live.
That’s the central theme behind Wellmont Health System’s outreach strategy for the upcoming open enrollment period that begins Nov. 1.
For the first time this year, the Kingsport, Tenn.-based integrated health system received a Navigator grant from the Centers for Medicare & Medicaid Services in order to expand their outreach and enrollment efforts in both Tennessee and Virginia. Their goal is to leverage their existing presence and community relationships in the 19 counties they serve to offer Health Insurance Marketplace navigation services for vulnerable populations living in the heart of central Appalachia.
The system includes five acute care hospitals, one critical access hospital, and more than 100 health care facilities in its predominantly rural service area of Northeast Tennessee and Southwest Virginia.
While nationwide enrollment soared by more than 50% during the past year, many people still do not know that they may be eligible for coverage. There could be more than 400,000 uninsured people in Tennessee who qualify for coverage, but have not enrolled, according to Jacob Flowers, the Tennessee director of Enroll America. One challenge is that many don't know there are tax credits to help offset the monthly premium.
To reach them, Wellmont is partnering with other organizations and branching out across its service area. Its outreach and enrollment team consists of four certified navigators who are assigned a specific geographic territory, with each navigator having a primary office location in one of their acute care hospitals. Activities will include events, emails, radio and television public service announcements and outdoor, web and social media advertisements.
Wellmont has invested in new technology to make it possible for outpatient sites to function as enrollment centers regardless of existing computer and internet accessibility. Investments have included items such as laptops, phones, iPads, mobile multifunction printers, voice over internet protocol (VoIP) telephone system.
“We heard from partners last year that they had the space to do events and build awareness but they might not have all the needed resources, like internet access and computers,” says Aaron Bentley, the system’s manager of outreach and enrollment. “This new technology allows us to partner with new organizations and go wherever large crowds are so we can facilitate both the increasing awareness and enrolling process.”
Wellmont plans to continue outreach throughout the year. “It’s important for us to stay visible and talk to people about coverage not just during open enrollment,” says Martha Pearson, the system’s director of patient access. “Otherwise it’s out of sight, out of mind.”
Internally, Wellmont has established a system-wide patient workflow that incorporates voluntary eligibility counseling for the uninsured to see if they qualify. Navigators can meet with individuals at the bedside or even reach out to them after they schedule an appointment, but before they see a doctor.
“Out in the community and at all the different levels of an individual’s interaction with the system, we’re able to get those referrals feeding into our navigators so they can talk about health coverage,” says Bentley. “We are really reaching them where they are.”
But at the end of the day it comes down to the message that Wellmont is sending: This isn’t just about enrolling in health coverage, but about helping make your upcoming year be your most healthy year yet.
“Having health insurance is just a part of a culture shift to becoming more proactive about being healthy,” says Pearson. “As a trusted source for information on all aspects of health care, we want to take it a step further and help individuals understand how to best utilize their coverage and be educated about what we have to offer that can help them improve their health.”