網頁

星期四, 2月 09, 2017

麻州健康聯絡者登記人數破紀錄

Massachusetts Health Connector Marks Record Enrollment and Strong Customer Service

BOSTON – The Baker-Polito Administration announced the results of the Massachusetts Health Connector’s recent Open Enrollment period that ended last week. The Connector successfully managed the highest enrollment totals of the Affordable Care Act (ACA) era, with significant applicant and member activity buttressed by strong customer service performance.

Enrollment for February 1st stands at over 246,000 people, the highest since the ACA was implemented and approaching the 252,000 in Health Connector coverage before 100,000 people became eligible for other coverage through Medicaid expansion in January 2014.

“Fixing the broken Health Connector and restoring a reliable customer service support system for the program were top priorities for our administration after taking office,” said Governor Charlie Baker. “Over the last two years, the Connector’s leadership and staff have worked tirelessly to transform the exchange into a functional and reliable service the people of Massachusetts deserve. While there is still work to do, I am proud of the work that has been accomplished to date and feel confident that the restored Health Connector can play a crucial role in the state’s health care structure.”

“The Health Connector plays an important role in ensuring communities across the Commonwealth have access to affordable health care,” said Lieutenant Governor Karyn Polito. “We are pleased to see such significant and targeted progress toward enrolling new people and look forward to continued progress for years to come.”

“The Health Connector is vitally important to our state’s commitment to making health care accessible to everyone,” said Secretary Marylou Sudders, Secretary of Health and Human Services. “Over the last two years, the Health Connector has gone from an agency hanging on to one that is home for thousands who need health insurance and a powerful advocate for universal coverage.”

The Health Connector started Open Enrollment on November 1, 2016 with 233,000 members, and retained more than 85 percent of those members despite many facing significant premium increases due to rate changes by some carriers. The Health Connector implemented a large member communication plan during Open Enrollment encouraging shopping, and more than 65,000 members switched plans for 2017. The 28 percent switch rate was four times higher than the usual 3-7 percent switch rate during an Open Enrollment.

In addition, 53,000 people who did not have coverage through the Health Connector enrolled in a plan for 2017. That is an increase of nearly 50 percent from the 36,000 new members added during 2016 Open Enrollment. The Health Connector’s new member strategy was fueled by an outreach effort focused on communities with higher rates of uninsured residents and that have been typically slow to sign up for coverage. In those targeted communities, new enrollments were 52 percent higher than 2016, with communities like Mattapan (93 percent) Chelsea (81 percent), Brockton (85 percent) and Everett (77 percent) experiencing the biggest increases. The Health Connector contracted with 16 community organizations through its Navigator program to help educate consumers about options available to them, and help uninsured people complete an application and select a plan.

“A successful Open Enrollment is reliant on support from the entire Commonwealth, including Governor Baker and Secretary Sudders, on through to our hard-working staff, our Navigators and assisters, and our customer service team,” said Louis Gutierrez, the Executive Director of the Health Connector. “I am grateful that we were able to capably handle the significant member activity we saw, which also serves as a reminder that Massachusetts values access to affordable, health coverage, and will continue to do so in the future.”

“After missing open enrollment last year and going  without health insurance, I was always worried. I learned coverage was necessary after breaking my leg a few years ago while playing rugby. If I hadn't been covered, the expenses would've been astronomical, this taught me that in today's world, you have to be sure you're covered in case of an accident,” said Vincent Daley, a Cambridge resident who signed up for coverage through the Health Connector during Open Enrollment with the help of a Navigator. “The staff at the Cambridge Economic Opportunity Committee walked me through the process and showed what I needed to do. Applying for health insurance is not something you’re taught. But, after learning the process, I even helped a friend apply for coverage, too.”

When Governor Baker took office in 2015, improving the Health Connector’s customer service was a top priority. Two years later, customer service outlets were able to successfully support a substantially high volume of calls and requests. Calls to the call center increased from 243,619 during 2016 Open Enrollment to 345,621 for 2017 Open Enrollment, an increase of over 40 percent. Visits to the Health Connector’s six walk-in centers increased from 14,710 for 2016 Open Enrollment to 17,711 for 2017 Open Enrollment, an increase of 20 percent. The customer service platforms were able to handle the additional traffic, particularly with the call center remaining within predetermined service levels for hold time and abandonment rates. Additionally, customer satisfaction scores remained near 80 percent satisfaction during this Open Enrollment.

(麻州州長貝克感謝劍橋市居民文森達雷通過健康聯絡者登記健保)
波士頓  貝克-白莉朵政府公佈麻州健康聯絡者登記人數於2月1日時超過246,000人,打破開辦以來最高紀錄。
21日生效健保的登記人數超過246000人,是自可負擔性健保法案實施以來的最高值;同時這一數字也逼近20141月麻州醫保補助擴張時允許10萬人有資格申請醫保前的登記人數,當時健康聯絡者幫助了252000人獲得保險。
「今年通過與安琪派拉格策略集團(Archipelago Strategies Group)合作,我們在聯絡少數族裔媒體方面取得重大進展,覆蓋了大範圍的不同語言,包括西班牙語、葡萄牙語、中文、海地語、越南語和高棉語等,」健康聯絡者執行主任路易斯·古鐵雷斯說,「同時我們還擴展了實地的基層工作,拜訪教堂、理髮店、英語課堂和其他不同地方。最終,這些努力獲得了回報。在我們去到的社區,去年新登記人數增加52%,部分社區甚至超過60%,如馬塔潘(Mattapan,過去一年增長93%),布羅克頓(Brockton85%),切爾西(Chelsea81%),埃弗里特(Everett77%),多切斯特(Dorchester68%)和昆士市(Quincy65%)。當你真正想要深入社區聯絡時,這就是外聯所帶來的成效。
「他們做了很多深入社區的聯絡工作,去到那些可能不太了解健康聯絡者,或是不知道健保開放資訊的社區,」州長查理貝克說道,「他們幫助馬塔潘、布羅克頓、多切斯特和昆士市大大增加了醫保覆蓋率。。。他們新增了5萬個登記,幫助7萬人更換了醫保計劃。」
健康聯絡者2016111日啟動開放登記,其233000名成員中85%以上選擇繼續使用該平台,儘管其中很多成員都因運營商調整費用而面臨保費大幅增長。健康聯絡者在開放登記期間實行了一個大型的成員聯絡方案來鼓勵購買保險,從而讓65000名成員在2017年得以轉換醫保計劃。此次28%的更換保險率是開放登記期通常3%-7%轉換率的四倍。另外還有53000位之前沒有保險的居民通過健康聯絡者登記了2017年的醫保計劃。這一數字比2016年開放登記期間增加近50%,去年的新成員人數為36000名。健康聯絡者的新成員戰略是通過對高比例無保險居民社區,以及通常較慢登記健保的社區進行針對性緊密聯絡來推動的。健康聯絡者與16個社區組織合作,通過其導航者項目來協助向客戶介紹他們可選擇的健保計劃,並且幫助無保險者完成申請和選擇計劃。
「在去年錯過了開放登記后,一直沒保險讓我總是處於焦慮擔心中。數年前我因為打橄欖球弄斷了腿,自那次起我認識到登記醫保的必要性。如果我當時沒有保險,醫療花費將是不可想象的,這教會了我,在今天這個世界,你必須保證自己有保險,以應對意外的發生,」一位通過健康聯絡者的導航者協助在開放登記期獲得保險的劍橋市居民文森達雷表示,「劍橋經濟機會委員會的工作人員給我講解了每一個步驟,並且告訴我哪些是我需要完成的。申請健保不是無師自通的。但是,經過學習了整個過程之後,我甚至得以幫助一個朋友完成了申請。」
當州長貝克2015年上任之時,改善健康聯絡者的客戶服務是他的首要任務之一。兩年后,客戶服務網點得以成功的支持大量的電話和咨詢要求。熱線中心收到的電話數量從2016年開放登記期的243619通增長到2017年開放登記期的345621通,增長率超過40%。健康聯絡者的六個步入式中心訪問人數從2016年開放登記期的14710人增加到2017年開放登記期的17711人,增長率約20%。客戶服務平台不僅協助處理額外業務,特別是在熱線中心按照預先設定控制電話等待時間和未接通率的情況下,得以發揮作用。另外,客戶滿意度在這個開放登記期一直保持在近80%滿意的水平。