Phone Outreach Nudges Among Individuals Losing Medicaid Coverage

Not Applicable

• Conditions: Behavioral Economics; Health Insurance
• Interventions: Behavioral: Phone Outreach; Behavioral: Standard Notice

• Registration Number: NCT06454019
• Lead Sponsor: Covered California

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-08-01
• Status Verified: 2024-06
• Study First Submitted: 2024-06-05
• Study First Submitted QC: 2024-06-10
• Last Update Submitted: 2024-06-10
• Study First Posted: 2024-06-12
• Last Update Posted: 2024-06-12
• Primary Completion: 2024-09-01
• Study Completion: 2024-11-01

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 60045

Inclusion Criteria

• 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

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Treatment Group with a phone call	Phone Outreach	Treatment group was assigned to receive a phone call from Covered California call center
Control Group without a phone call	Standard Notice	Control Group was assigned to receive no phone outreach

Primary Outcome Measures

Name	Time	Method
Health Plan Effectuation	within 30 days from the start date of plan they are auto-enrolled into	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

Secondary Outcome Measures

Name	Time	Method
Tenure with Covered California (measured in months)	measured 1-2 years after the intervention	A length of tenure with Covered California plan within calendar year and/or beyond
Emergency Room Visit	measured 1-2 years after the intervention	A binary indicator for whether someone had an emergency room visit during 1-2 years since the intervention
Office visit	measured 1-2 years after the intervention	A binary indicator for whether someone had an office visit during 1-2 years since the intervention
Prescriptions filled	measured 1-2 years after the intervention	A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention
Hospital admission	1-2 years before and after the intervention	A binary indicator for whether someone had a hospital admission 1-2 years before and 1-2 years after the intervention
Uninsured	measured 1-2 years after the intervention	A binary indicator for whether someone self-reported being uninsured while filing their taxes
Out-of-pocket spending on healthcare services	measured 1-2 years after the intervention	Total out-of-pocket spending for the 1-2 years since the intervention

Trial Locations

Locations (1)

Covered California; 🇺🇸 Sacramento, California, United States