Navigator and Certified Application Counselor Technical Advisory Committee - PowerPoint Presentation

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Navigator and Certified Application Counselor Technical Advisory Committee

January 18, 2018

1

Slide2

Members

2

Angela Ward

Northeast Washington Health Programs

Curt

Fackler

Better Health Together

Jennifer Dyrseth

Olympic Medical Center

John Bennett

Choice Regional Health Network

Mary Wood (Outreach)

Health Care Authority

Odin

Ifrim

Valley Medical Center

Randy Moyer

Legacy Health

Rhonda

Hauff

Yakima Neighborhood Health Services

Todd Dixon

Office of the Insurance Commissioner

Venus Tarbell

Puyallup Tribal Health Authority

Slide3

Agenda

UpdatesOpen

Enrollment Navigator

Survey Results and

Discussion

Wrap Up

3

Slide4

Updates

Very successful open enrollment (more to come!)

State Legislative sessionMarket Stabilization

Reinsurance

Individual Mandate

Bare Counties

Public Option

Enabling statute clean up

COFA Islanders (Marshall Islands, Palau, Micronesia)

Federal activity

Regulations

Tax bill repeals individual mandate in 2019Year-end budget package (CHIP, CHC funding)

4

Slide5

Updates – Open enrollment

2017

2018

Increase

Effectuated

QHPs selected

220,000

242,800

10%

53%

New QHPs

68,000

79,000

16%

Total QHP renewals155,000164,0005%

5

Slide6

Enrollment Summary 1-15-2018

6

As of

1/15/2018

Total QHP

242,800

100%

Renewal

164,000

68%

New

79,000

32%

Subsidized

152,500

63%

Unsubsidized

90,400

37%

Effectuated

129,000

53%

Slide7

By Carrier

Total Enrolled

Percent of Total QHP

Enrollment

Total New

Total Renewal

Kaiser Permanente

WA

83,000

34%

28,000

55,000

Coordinated Care

62,600

26%19,60043,000Premera39,30016%16,000

23,200

Molina

32,000

13%

7,600

24,500

LifeWise14,5006%4,30010,200Kaiser Northwest10,8004%3,1007,600Bridgespan700.2%200500Total242,900100%78,800164,000

7

Numbers are rounded

Slide8

Dental

Type/Status

Total Number

Percent of Total

Total QDP

52,000

100%

Renewal

21,000

40%

New

31,000

60%

Effectuated

18,200

35%

8

Slide9

Navigator Assisted – November/December

Total QHPs

Toward Incentive

Incentive Target

% of Target

Better Health Together

1,392

1,258

1,936

55%

CHOICE

549

528

2,122

26%Confluence8227941,49053%

Kitsap

Public Health District

193

177

696

25%

Korean Womens Association42942950086%Sea Mar – Pierce1,2227582,81737%Sea Mar – Jefferson/Clallam344135011%Sea Mar–Clark/Klickitat/Skamania6365571,76531%Seattle-King County Public Health6,043

5,5804,397125%

Tri-Cities Community Health

506

482

1,585

30%

Whatcom Alliance for Health Advance.1,6811,6303,60845%Yakima Neighborhood Health Services8538142,04140%Total14,36013,04823,30756%

9

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Storefront Enrollments November-December

# QHP

QHP Target

% of Target Met

WAH

Total visitors

Applied Team Insurance - Vancouver

343

1,200

29%

14

294

Cornerstone Insurance – Tukwila

434

1,000

43%

33

309

GHB Insurance – Olympia

529

1,300

41%19470

Warshauer

Insurance – Vancouver

205

2,500

8%

49

652Better Health Together – Spokane39650079%

180

735

PHSKC – Federal Way1131,00011%582492,0207,50027%3532,488

10

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Reports/Incentives

Full OE 5 enrollment reports available soon!By county

Storefronts

Details in supplemental info at end of PPT

Review final OE results at March meeting

Lead Organization contract expires in June 2018

Renewable

Confirming allocation with Finance

CMS Cost allocation changes

Review

ytd

results and determine whether to extend or re-procure in any areas of the state11

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Discussion

What, if anything, was different in OE5?

Areas where enrollment was higher or lower than expected? (Scroll down to see Lead Org results by county)

Insights about these results?

Strategies that worked or didn’t work

?

Experiences/thoughts on storefronts?

12

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2018 Navigator Survey

13

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Navigator Survey

Sent to Navigators, CACs, Tribal Assisters, Enhanced Users (800-ish)34

questionsNavigator and Navigator Organization

Training

Washington Healthplanfinder

Support

Almost 400

responses

Sharing

your navigator

feedback

Forward link to navigators and encourage completionFeedback from your navigators coming soon!14

Slide15

Section 1 – Navigators and Navigator Organizations

15

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Navigator Survey

16

293

15

25

18

328

15

26

18

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Q2 Respondents by County

17

Adams

6

Asotin

0

Benton

2

Chelan

15

Clallam

9

Clark

8

Columbia

0

Cowlitz

8

Douglas

1

Ferry

1Franklin5Garfield0Grant9

Grays Harbor

4

Island

0

Jefferson

0

King137Kitsap15

Kittitas

1

Klickitat0Lewis5Lincoln1Mason3Okanogan6Pacific1Pend Oreille0Pierce

27

San Juan

2

Skagit

2

Skamania

1

Snohomish

20

Spokane

27

Stevens

2

Thurston

12

Wahkiakum

0

Walla

Walla

1

Whatcom

20

Whitman

1

Yakima

32

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3. Length of time as a navigator

18

150

18

32

62

123

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4. QHP volume

19

45

58

126

132

24

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5. WAH volume

20

73

79

127

101

5

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6. Service to vulnerable populations

21

142

143

81

20

74% (285)

(77% in 2017 survey)

Slide22

7. Reasons people need assistance

22

130

111

63

48

18

17

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8. Your organization’s target groups

Multiple choice responses

Own patients/clients

225

Low wage workers/low income/ unemployed

179

Homeless people

165

Immigrants, refugees,

asylees

, undocumented

157People with disabilities/chronic conditions113Seniors

105

College

students105Rural residents99Migrant workers88

Teens

86

LGBTQ

73

23

“Other responses”

People with HIV/AIDS3Alcohol/substance abuse patients2Other target groups:Children2Recently released from incarceration2Pregnant women with low income2

Private pay patients1

No target groups

83

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9. Racial/ethnic target groups

24

226

74

51

117

86

66

7

3

Middle Eastern, 2

Indian, 2

Somali, 2

Burmese

Other responses

Slide25

10. Limited English Skills

2017

2018

Always or most of the time

14%

18%

+4%

More than half of the time

19%

28%

+9%

Less than half of the time

30%

30%

No changeNever or almost never37%

24%

-13%

25

Q10. Limited English speaking skills is a barrier to enrollment for my customers

Slide26

11. Concepts customers find difficult

26

76%

5

6%

43%

41%

44%

25%

10%

Slide27

12. Broker referrals

27

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13. Reason for not referring to Broker

28

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Discussion

29

Priority

H-M-L

#1 reason people need help is lack of knowledge about insurance. There are also

specific concepts that are difficult for existing customers

– is there a larger role for navigators or lead organizations?

Are there underserved target groups that we need to connect with or increase our efforts with?

Are there additional language services or supports we need or want to explore?

It looks like navigators see some customers that they believe could benefit by talking to a broker. Are there steps/strategies we can and want to pursue to increase customer acceptance/confidence/trust in brokers?

Other:

Other:

Slide30

Section 2 – TRAINING AND CERTIFICATION

30

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14. Navigator level of knowledge

Need training or refresher

(All

Nav

)

Need training or refresher

-

5

year

navs Need training or refresher 1-4 year navs American Indian/Alaska Native provisions61%32%

74%

Cost sharing reductions

52%32%65%Tax filing requirements47%28%

60%

Silver plan benefits

41%

15%

50%

Tax credits

38%19%53%QHP comparison 33%18%36%Out of pocket expenses25%13%35%Special enrollment periods22%14%32%31

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15. In-Service Training

32

131

25

33

18

156

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16. Usefulness of in-service training

33

127

74

12

134

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17. Reason did not attend

34

19

17

50

46

226

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18. How to improve in-service training

Themes Logistics:

Start on time, stay on time

Format to ensure people can attend the courses they need/want (rooms got full), and better organization around breakouts

More and/or different locations that would geographically cover the state better

More audience

participation

Content:

Scenarios, complex cases

Tax credits, tax filing requirements

35

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19. Monthly training webinars

36

48

212

25

16

41

Slide37

20. LMS Ease of Use

37

195

134

31

6

90%

Slide38

21. LMS difficult areas

38

45

60

77

39

36

180

Slide39

Q22 – Support/resource needs

39

ThemesTraining

Long modules are difficult – attention, disruptions

Speak slowly, clearly

Ensure test material is in the PPT (need speaker notes)

Testing

Wording of questions is sometimes confusing/tricky

No feedback on missed questions

Slide40

Table discussion

In-service training

Continue in 2018?High level input

Planning group meet to consider feedback and develop a plan for 2018

Thoughts/ideas

– how to improve navigator level of knowledge

Resume training

group

Navigator webinars

Training time for navigators

40

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Section 3Washington

Healthplanfinder

41

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23. Healthplanfinder Response Time

42

274

37

50

Slide43

49 reported extended waiting

43

1-2 min.

12

2-5 min

12

5-10

11

10-15

4

Up to 30 minutes or more

7

Locks

up

5

Slide44

24. Use of Smart Planfinder

44

82

77

99

102

Slide45

25. Usefulness of Smart Planfinder

45

125

149

79

Slide46

26. Smart Planfinder improvements (62)

Top issues reported:

Inaccurate information in the provider directory

Inaccurate prescription coverage

information

Limited plan options

46

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27. Expedited renewal flow

47

186

109

15

49

Slide48

28. Expedited renewal flow suggestions

Navigators frequently end up in the full renewal flow

Need more updates to be submitted without redirecting to the full renewal flow

Could use it more often if tax filing status were in application review

Ability to choose tax filing status on one page for everyone

System would indicate when all household members are updated

Changes that need to be reported are missed when using expedited renewal

48

Slide49

29. Healthplanfinder improvements (129)

49

Most

Recommended

Second most frequent

Search

For accounts with multiple applications, do not display old, inactive applications or make it clear which application is the current, active application to be used for updates

and who is the primary applicant.

Eliminate requirement

to have SSN to search for a customer (very close second)(coming soon!)

Account Creation

Improve the process for creating

a new application for someone who ages out of a HHD but still resides there. Clone and edit rather than re-enter the whole application.Simplify the user ID and password requirements. System performanceSlow response time; timing out; errors – esp. related to receiving auth. Codes, HHD composition, and searching for someone who is undocumented.Navigation

Ability to submit changes without

clicking through each page of the application

.

Improve

expedited renewal.

Documents

Ability to view uploaded documents.Correspondence related to required documents is vague and confusing.

Slide50

Suggested new features

1

Display APP ID on all pages for reference

2

Ability to add notes

3

Display whether FTI box is checked

4

Easy way to update tax filing status of entire HHD

5

Provide quick tips on a side panel

6Auto-populate fields throughout application if the

information has been entered already.

7

Display authorized rep8Indicator that highlights which parts of the application are incomplete9Better questions/explanation around employer-sponsored insurance

10

Have system-generated ID and password that is editable by

choice

11

Ability to enter applications for minors who do not live with an

adult or relative

12Ability to edit the records/links on dashboard – very cluttered after 5 years13Ability to select a Medicaid plan when Provider 1 is down50

Slide51

Table Discussion

Improvements/new features that would have the greatest impact…in order of highest priority to lowest

.Ideas for increasing use of Smart

Planfinder

.

51

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Navigator Support

52

Slide53

30. Support for QHP issues

53

135

60

60

97

Slide54

Navigator Responses

Contact the Lead Organization

135

38%

Contact the Call Center

60

17%

Look for online resources

60

17%

Ask my supervisor or co-workers

97

28%

347

100%54

Slide55

31. Frequency of Call Center use

55

40

57

107

148

Slide56

32. Navigator Call Center usage

Several times a week

40

11%

Once or twice a week

59

16%

Once or twice a month

107

30%

Never or almost never

148

42%

354

100%56

Slide57

Response time of support

2 days+

1-2 days

Within 24 hours

Within 2 hours

Immediately

Lead Organization

6%

11%

15%

22%

46%

HBE Call Center

7%

9%13%31%40%HCA Community Based Specialist3%

10%

20%

20%

46%

HCA Call Center

7%

8%17%33%35%57

Slide58

33. Navigator News

58

146

141

54

12

Slide59

34. Additional comments

Training

Navigators who do not get uninterrupted time for training/testingMore information or a guide on where to go for help – HCA, Lead Org, troubleshooting guide, Call Center

Everything related to taxes and tax credits, including a printed document to provide to individuals

59

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Discussion

How did navigator support go this OE?Real time support

Common system issues

Feedback on Navigator news

Other needs/suggestions on supporting navigators?

60

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Supplemental info

61

Slide62

BHT by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Adams

78

73

107%

Ferry

2

34

6%

Lincoln

172181%Pend Oreille

8

34

24%

Spokane

803

1,433

56%Stevens5320027%Whitman71415%Blank9362

Better Health Together

Slide63

CHOICE by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Cowlitz

115

331

35%

Grays Harbor

68

295

23%

Lewis

45

349

13%

Mason

91

219

42%

Pacific76012%Thurston15186517%Wahkiakum33

100%

Blank

48

63

CHOICE Regional Health Network

Slide64

Kitsap PHD by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Kitsap

177

696

25

64

Kitsap Public Health District

Slide65

NCW-Confluence Health by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Chelan

239

291

82%

Douglas

131

173

76%

Grant

182

790

23%

Okanogan

157

236

67%

Blank8565Confluence Health

Slide66

PHSKC

Enrolled as of 12/31

OE5

Target

% of Target Met

King

5,486

4,397

125%

66

Public Health Seattle-King County

Slide67

Sea Mar by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Clallam

24

275

9%

Clark

542

1,659

33%

Jefferson

16

75

21%

Klickitat

11

53

21%

Pierce10342,81737%Skamania1

53

2%

67

Slide68

TCCH by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Asotin

0

79

0%

Benton

166

799

21%

Columbia

13

10

130%

Franklin

182

447

41%

Garfield050%Walla Walla9424538%Blank27

68

Tri-Cities Community Health

Slide69

WAHA by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Island

32

166

19%

San Juan

32

4

800%

Skagit

241

275

88%

Snohomish

507

2,512

20%

Whatcom63565198%Blank183

69Whatcom Alliance for Health Advancement

Slide70

YNHS by County

Enrolled as of 12/31

OE5

Target

% of Target Met

Yakima

746

1,672

45%

Kittitas

33

369

9%

Blank

35

70

Yakima Neighborhood Health Services