Evolution of Outreach: Evaluation of Enroll America's Efforts to Support ACA Enrollment

Publisher: Ann Arbor, MI: Mathematica Policy Research
Nov 20, 2015
Authors
Sheila Hoag, Cara Orfield, and Sean Orzol

Key Findings:

  • Enroll America built on its successes from the first open enrollment period to enhance and expand outreach during the second period, reaching more consumers with fewer resources. Effective tactics that emerged during the second open enrollment period included developing an online scheduling tool, the Get Covered Connector, which permitted consumers to schedule enrollment assistance appointments online; renewing its emphasis on partnerships, including asking existing partners to integrate Enroll America strategies into their own operations, and identifying new partners, such as insurance agents and brokers, many of whom became integral allies in this work; and refining strategies based on evidence suggesting modifications (such as shifting from large-scale enrollment events to stationary enrollment sites) could boost results.
  • Enroll America’s consistent record of achieving its goals is largely due to (1) its emphasis on using a rapid-cycle data and analytics approach to make midcourse corrections across all the other aspects of its campaign; (2) its ability to recruit, train, and retain talented and motivated staff; and (3) development of effective partnerships that support local buy-in and provide access to the target population.
  • Although Enroll America was never intended to be a permanent organization, even its short-term sustainability is not assured, because support for outreach activities has waned since the first open enrollment period.  Enroll America’s future plans to increase revenue sources (including diversifying funding sources; shifting some fund-raising responsibilities to field states; and developing sources of earned revenue, such as customized training) hold promise for helping the organization sustain its work, but its diminished capacity comes at an inopportune time, because ongoing efforts to undermine the ACA might be strengthened should coverage growth begin to taper off.

Mathematica Policy Research examined the implementation of Enroll America’s field outreach campaign during the second open enrollment period, to (1) understand whether and how it adapted the campaign compared to its first year activities, (2) assess second-year performance, and (3) document Enroll America’s expectations for its work in 2015 and beyond. 

Data sources include two rounds of interviews with Enroll America staff and outside stakeholders conducted in October and November 2014 and again between May and July 2015. We identified the main research themes of interest to develop a coding scheme, including code names and definitions; these codes were applied to all transcript notes in Atlas.ti. Researchers also reviewed publicly available documents and media reports, as well as documents supplied by Enroll America staff, such as organization charts, reports, promotional materials, media stories, and examples of materials used at sites. Finally, to assess Enroll America’s performance in the second open enrollment period and compare it to performance during the first open enrollment period, we examined many key metrics, some provided by Enroll America (such as the number of volunteers, media hits, and commit cards collected) and some obtained from outside sources (such as data on enrollments and renewals in the FFM). 

We found that Enroll America built on its successes from the first open enrollment period to enhance and expand outreach during the second period, introducing some new effective tactics, including developing an online scheduling tool, renewing its emphasis on partnerships, and refining strategies based on evidence. An analysis of available descriptive data suggests Enroll America met or exceeded its first-year outreach efforts during the second open enrollment period, despite fewer available resources (such as paid field staff and volunteers), a shorter open enrollment period, and a population that became harder to find this year. Although Enroll America was never intended to be a permanent organization, even its short-term sustainability is not assured, because support for outreach activities has waned since the first open enrollment period.  Enroll America’s future plans to increase revenue sources hold promise for helping the organization sustain its work, but its diminished capacity comes at an inopportune time, as ongoing efforts to undermine the ACA might be strengthened should coverage growth begin to taper off.