State of Enrollment: Lessons Learned and the Way Forward

© 2014 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
State of Enrollment Report: Lessons
Learned and the Way Forward
July 10, 2014

Agenda
Welcome
Sophie Stern
Deputy Director, Best Practices Institute
Digital Outreach and
Analytics
Adam Stalker
National Digital Director
Grassroots Organizing and
Earned Media
John Gilbert
National Field Director
The Power of Collaboration
Jose Plaza
National Latino Engagement Director
Key Takeaways and Q&A
Sophie Stern

EnrollAmerica.org | GetCoveredAmerica.org3
Who Are We?
Two-‐fold
Strategy

Our
Mission

Maximize the number of uninsured Americans
who enroll in health coverage made available by
the Affordable Care Act
Promo&ng
Enrollment
Best
Prac&ces

Na&onal
Enrollment
Campaign
Using
Cu7ng

Edge
Engagement
Strategies

1

2

67% of the uninsured lived in 13 states and 50% lived
in just 113 counties

Available on-line here
https://
s3.amazonaws.com/
assets.getcoveredameric
a.org/
20140613_SOEReportP
DFlr.pdf

Lessons Learned through Enroll America’s Get
Covered America Campaign & Partner States
Individuals Connected to
New Coverage Options

Why A Digital Focus?
•  Meeting consumers where they are
o  91% of Americans own mobile phones
o  87% actively use the internet
•  It’s where they get news and information
o  More women than men on social media
o  Latinos and African Americans over index for
social media
•  Digital is more cost effective

© 2014 GET COVERED AMERICA | GetCoveredAmerica.org
Digital Topline Results
1.85 million unique users
1.1 million consumer email
addresses
5 million page views
380,000 people connected to
marketplace or assistance
9

Sample Online Banner Ads
10

Digital Paid Media Overview
•  1.1 million email addresses
•  Digital paid media was responsible for
more than 87% of all email acquisition
•  Efficiencies improved by 95% after
shifting paid media strategy in early Q4
to geo-targeting ZIP codes with
highest rates of uninsured instead of
trying to target uninsured consumers
online
12.61%
66.36%
11.11%
5.59%
2.42%
1.91%
Email Acquisition by Source
Earned Sources
Lead Gen
Paid Search
Text Links
Display/Banner
Paid Social
11
Source: Enroll America Digital Program

Improving Efficiencies Of Paid Media
$-
$20
$40
$60
$80
$100
$120
-
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
1,000,000
1-Oct
8-Oct
15-Oct
22-Oct
29-Oct
5-Nov
12-Nov
19-Nov
26-Nov
3-Dec
10-Dec
17-Dec
24-Dec
31-Dec
7-Jan
14-Jan
21-Jan
28-Jan
4-Feb
11-Feb
18-Feb
25-Feb
4-Mar
11-Mar
18-Mar
25-Mar
EffectiveCPA
ConsumerEmailsAcquired
Campaign CPA Consumer Emails
12

Consumers Are Mobile
Compared to the general internet audience, Get Covered America’s audience over-
indexed heavily for smartphones – almost 5.4x the internet average.
And 45% of site traffic came from mobile devices.
(0.33)
5.36
0.55
(2.00)
(1.00)
-
1.00
2.00
3.00
4.00
5.00
6.00
Enroll America
IndexoverInternetAverage
Devices
used
to
connect
to
internet

55%
36%
9%
Devices used to connect to GCA.org
Desktop
Mobile
Tablet
13 Source: Enroll America Digital Program

Who Was Our Typical Consumer?
•  The audience most likely to connect from GetCoveredAmerica.org to their
state marketplace*:
•  Adults 25-44 and 55-64
•  Household income $15k-$49k
•  Single, Females
*Data from one display media partner but results consistent with other partners

Urgency Changed Over Time
•  Consumers that connected to their
Marketplace in Q4 2013 displayed
“early mover” characteristics by
connecting to their Marketplace
after being on the GCA email list for
8 days
•  Compare that to consumers that
took 33 days to connect to their
Marketplace in March and April
2014, more than 3x as long as
those in Q4 2013
7.69
14.11
32.50
0
5
10
15
20
25
30
35
Q4 2013 Jan 1-Feb 28 2014 Mar 1-Apr 15 2014
Days
Average # of days on email list before
connecting to Marketplace

Follow Up Through Multiple Mediums
0.00% 1.00% 2.00% 3.00% 4.00% 5.00% 6.00% 7.00%
Overall
Phone & Email
Phone Only
Improvement in Enrollment Rate in the Last Month
Among Uninsured Caused by Follow-Up Program

Lessons Learned: Digital Message Testing
1.  Personal stories didn’t resonate as
well as individualized help
2.  “Affordability” was the biggest driver of
engagement, but some messages are
better than others:
o  Be specific, include dollar figures
o  Don’t talk about savings, use real
examples of monthly cost
o  “Salesy” language was a deterrent
3.  The fine was a strong motivator
4.  Avoid political or non-profit fundraising
style language – this is a consumer
marketing campaign

Examples of Winning Messages
•  “Free, in-person help with your
health insurance application.”
•  "Gail R. from Pennsylvania got
covered for $1.11 per month.”
•  ”Over half of uninsured Americans could get
covered for less than $100 a month.”
•  “Sign up by March 31st to avoid
paying a fine.”

Agenda
Welcome
Sophie Stern
Digital Outreach and
Analytics
Adam Stalker
National Digital Director
Grassroots Organizing and
Earned Media
John Gilbert
National Field Director
The Power of Collaboration
Jose Plaza
National Latino Engagement Director
Key Takeaways and Q&A
Sophie Stern

Grassroots Organizing And Earned Media
Enroll America state staff focused on
building an organization comprised of
volunteers and partners, working within local
coalitions that could accomplish two goals:
1.  Engage consumers directly around
enrollment and link them directly to
enrollment assistance
2. Create earned media opportunities
around enrollment education

Volunteer And Shift Growth
Source: Enroll America Field Program

Event Participation Growth

•  [Insert text]
•  [Insert text]
Consumer Outreach

Commit Cards Signed By Consumers

Increase In Enrollment Rate After Multiple
Contacts

Contact Increased Enrollment
0%
40%
80%
120%
160%
200%
Overall" African American" Latino" Youth"
Growth in Enrollment Rate by Number of Volunteer
Follow-Ups!
After First Follow-Up" After Second Follow-Up" After Third Plus Follow-Up"

Enrollment Event Growth

Different Consumer Leads From Digital
And Field
Source: Enroll America Field & Digital Program

Access to a national database of consumers
•  Access to target outreach efforts for door to door contact or tabling events
Produce Outreach Tools
•  Easily creates canvass packets and phone lists to support your outreach
Track Consumer Conversations
•  Keep track of contact attempts, conversations, and follow ups
Maintain and Report On the Data You Collect
•  Customizable data entry tools and sophisticated reporting options
Manage Volunteers
•  Track the status of volunteers as they sign up for and complete shifts
Get Covered Data (GCD)

Earned Media Campaign In Action

Earned Media In Enroll America’s 11
Campaign States

Earned Media Campaign In Action
ARTICLE QUANTITY AND FAVORABILITY
INCREASED AS MARCH DEADLINE APPROACHED
Source: Enroll America Communications Program

Results From EA Nationwide Survey
0
5
10
15
20
25
30
35
40
45
50
News Advertisements Website/online searches Friends and family
Where have you been getting information about the new
health insurance options including HealthCare.gov?
Enrolled Uninsured

Results from EA Nationwide Survey
0
5
10
15
20
25
30
35
40
45
50
News Advertisements Website/online searches Friends and family
What has been your MAIN source of information about new
health insurance options including HealthCare.gov?
Enrolled Uninsured

Results from EA Nationwide Survey
0
5
10
15
20
25
30
35
40
45
50
Local TV National/Cable TV Print Radio Online
Enrolled Uninsured

Lessons Learned: Grassroots
Organizing & Earned Media
Lessons Learned
•  Following up multiple times yielded
the best results, specifically
among certain populations.
•  Collecting information using a
“commit card” was an effective and
simple way to collect consumers’
information for follow-up.
•  Following up with consumers over
the phone was one of the most
important tools Enroll America staff
employed. The increase in
enrollment was the strongest
among consumers Enroll
America was able to both call
and email.
Source: Enroll America, State of Enrollment: Lessons Learned from Connecting America to Coverage,
2013-2014, https://s3.amazonaws.com/assets.getcoveredamerica.org/20140613_SOEReportPDFlr.pdf
Lessons Learned
•  Engaging ethnic and
specialty media and
other trusted sources
of information and
messengers was
crucial
•  Educating staff about
the importance of
building relationships
with reporters and
executing an overall
communications and
messaging strategy
was key

Partner Engagement – National, State
and Local
Engage Local
Communities
Fill Resource
Gaps
Trusted
Messengers
Communications
Echo Chamber

Our Partnership Approach
Large-Scale Convening
Policy & Grounded
Practical Guidance
National & State
Partnerships

Reaching the Uninsured with Partners
National Community College PartnershipYouth
•  70 Events across 25 States
•  500,000 students reached
National Coalition of Latino OrganizationsLatinos
•  60+ Events across 25 cities: Over 15,000 served in person.
•  Media, elected officials, and community partners engagement
Reaching Communities of Color through FaithFaith
•  1,500 events at churches, mosques, & synagogues
•  Coalition represented over 20 million diverse congregants

Reaching The Uninsured With Partners
Hospitals, Health Centers, & ProvidersHealth Systems
•  Developed health provider toolkits, trainings, messaging, and
technical assistance to aid in outreach & enrollment.
National Mayors Month of ActionCities
•  Established partnership with mayors across the country to co-
host press conferences, outreach & enrollment events, and op-
eds.
Reaching Consumers In-PersonPharmacies
•  Partnered with CVS retail pharmacies and through 130 events
reached more than 11,000 individuals across the country.

Lessons Learned
•  Meet people where they are at with messengers
they trust
•  Build coalitions with local partners & media outlets
•  Engage navigators & certified application
counselors (CACs) for in-person assistance that is
consumer friendly & culturally-competent.
•  Encourage partners to become CACs, send
information to consumers through their
communication channels, and join efforts.

Key Takeaways
Financial assistance messages were key
Consumers wanted individualized information
Following up multiple times yielded the best
results, specifically among certain populations
Partnerships drove success
In person help was crucial

How to Replicate: Work With Us
Support
Outreach
&
Enrollment
GCD
training and
support
Advanced
outreach
trainings
Topical
webinars
Share best
and
promising
practices
Assist local
partnerships
Continue
research
and learning

Resources
•  State of Enrollment: Lessons
Learned from Connecting America
to Coverage, Enroll America, June
2014,
http://www.enrollamerica.org/
soe_report/
•  Voices from the Newly Enrolled and
Still Uninsured: A Survey about the
Affordable Care Act’s First Open
Enrollment Period, PerryUndem
Research & Communication and
Enroll America, July 2014,
http://www.enrollamerica.org/
resources/public-education/voices-
from-the-newly-enrolled-and-still-

Q&A

State of Enrollment: Lessons Learned and the Way Forward

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