Phone Outreach Nudges Among Individuals Losing Medicaid Coverage

NCT06454019 | Enrolling By Invitation

• 1 other identifier: SB260-OCC-2023
• Study Type: interventional
• Target: 60,045
• Locations: 1 country
• Sites: 1

Brief Summary

In May 2023, Covered California, California's ACA marketplace, implemented its automatic enrollment program for individuals losing Medicaid coverage, as defined by Senate Bill 260. If individuals are found eligible for subsidized marketplace coverage, individuals will be automatically enrolled in the lowest cost silver plan available to them, but individuals must still take action to confirm their plan or pay their first month's premium. To identify whether the phone outreach is the effective outreach strategy to increase take-up in this population, Covered California implemented this intervention. The results of this evaluation will inform operational and budgeting decisions.

Conditions

Behavioral Economics; Health Insurance

Keywords

Health Insurance; ACA marketplace; Behavioral Economics; Nudge

Outcome Measures

Primary Outcomes (1)

• Health Plan Effectuation

  A binary indicator for whether a consumer is effectuated into (paid for, opt-in into) Covered California plan, either the plan assigned through the auto-enrollment process, or into another plan chosen by the consumer by the end of the month at which outreach was conducted

  within 30 days from the start date of plan they are auto-enrolled into

Secondary Outcomes (7)

• Tenure with Covered California (measured in months)

  measured 1-2 years after the intervention

• Office visit

  measured 1-2 years after the intervention

• Prescriptions filled

  measured 1-2 years after the intervention

• Emergency Room Visit

  measured 1-2 years after the intervention

• Hospital admission

  1-2 years before and after the intervention

Study Arms (2)

Control Group without a phone call

EXPERIMENTAL

Control Group was assigned to receive no phone outreach

Behavioral: Standard Notice

Treatment Group with a phone call

EXPERIMENTAL

Treatment group was assigned to receive a phone call from Covered California call center

Behavioral: Phone Outreach

Interventions

Phone Outreach BEHAVIORAL

Phone outreach to individuals losing Medicaid and auto-enrolled into Covered California plan to nudge them to act

Treatment Group with a phone call

Standard Notice BEHAVIORAL

Standard notification letter without phone outreach to individuals losing Medicaid and auto-enrolled into Covered California plan to nudge them to act

Control Group without a phone call

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Lost Medi-Cal (California's Medicaid coverage) in July 2023-June 2024
• Auto-enrolled into lowest cost silver plan with Covered California as per Senate Bill 260 and have not opted-in (effectuated) into the coverage
• Have a valid phone number on the health insurance application
• Do not have a delegated agent to their case
• Still have Covered California Program eligibility, not reverted back to Medi-Cal coverage
• Have English or Spanish as preferred speaking language

Sponsors & Collaborators

• Covered California: lead

Study Sites (1)

Covered California

Sacramento, California, 95835, United States

Location

Study Officials

• Emory Wolf, MPP

  Covered California

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Research Data Scientist

Study Record Dates

• First Submitted: June 5, 2024
• First Posted: June 12, 2024
• Study Start: August 1, 2023
• Primary Completion: September 1, 2024
• Study Completion: November 1, 2024
• Last Updated: June 12, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP
• Time Frame: Data will be available with investigator support upon publication
• Access Criteria: Replication data can be accessed via request to the primary investigator upon publication.

Locations

US (1)