Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality

Office of Evaluation Sciences

Status: Completed

Conditions: Health Behavior

Treatments: Behavioral: Emails and letter intervention; Behavioral: Control group

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT05216458

05272021

Details and patient eligibility

About

With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $0 -- or $1 per member per month (PMPM) in Marketplaces that include abortion coverage -- health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine whether personalized letters and email reminders can increase health insurance enrollment, CSR Silver take-up and $1 PMPM coverage.

Enrollment: 44,000 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Submitted a Covered California application for the 2021 coverage year and found eligible for a $1 PMPM Enhanced Silver 94 plan

Exclusion criteria

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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44,000 participants in 3 patient groups

Control

Experimental group

Description:

Households in the control group did not receive any messages during the intervention period from June 2021 to August 2021

Treatment:

Behavioral: Control group

Generic Outreach

Experimental group

Description:

Households in the generic outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees, which explain that nearly all Covered California members get subsidies to pay for health insurance and encourage them to explore their plan options using an online Shop \& Compare tool. For the generic arm, the outreach materials described new financial assistance under the American Rescue Plan and noted the availability of plans as low as $1/month.

Treatment:

Behavioral: Emails and letter intervention

Personalized Outreach

Experimental group

Description:

Households in the personalized outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees. For the personalized arm, the outreach explicitly informed the household that they were eligible for a $1/month CSR Silver 94 plan and described the benefits this plan confers. The outreach materials for the personalized group were not only designed to increase enrollment, but also to simplify the search process by providing households with a clear recommendation to pick a CSR Silver plan; this included highlighting the low out-of-pocket costs these plans provide when accessing care, a screenshot of what the plan would look like when they entered the shopping portal and peer comparison language that noted 9 out of 10 consumers like them choose CSR Silver plans

Treatment:

Behavioral: Emails and letter intervention