Healthcare Reform

How CHRISTUS Health Supports Exchange Enrollment

February 9, 2016 2:10 pm

The health system is seeing positive results from its efforts to encourage patients to enroll in health insurance exchanges, including the finding that one third of exchange plan patients have been treated previously as uninsured patients.

After three health insurance exchange open-enrollment periods, CHRISTUS Health is feeling great about its progress so far.

“It’s just incredible to be able to help people access insurance, in many cases for the first time,” says Abby Lowe McNeil, system director for communication and public affairs. “This is such a great intersection of stability for our health system and we are providing services that people really need.”

CHRISTUS Health, a not-for-profit health system based in Irving, Texas, serves 60 cities in Texas, Arkansas, Louisiana, and New Mexico. McNeil, who shares exchange enrollment leadership with the health system’s vice president for advocacy, says the public exchanges are a great asset for CHRISTUS. A recent analysis of utilization by 2014 exchange enrollees found that the system is seeing a positive financial return from exchange enrollee claims.

  • One third of patients covered by health insurance exchange plans that CHRISTUS served in 2014 were new to the system.
  • One third of exchange plan patients have been treated previously at CHRISTUS as uninsured patients.
  • One third of patients covered by exchange plans previously had government or private insurance when they were treated at CHRISTUS.

Working Collaboratively

Each year, the system’s health insurance exchange committee plans its enrollment efforts, building on lessons learned from the previous year’s campaign and incorporating new knowledge about the evolving pool of uninsured Americans. The committee develops its strategy each year based on research about the uninsured population from Enroll America—the national health care enrollment coalition—and the Robert Wood Johnson Foundation.

That strategy includes:

  • Assigning regional executives to be accountable for exchange plan enrollment in their regions
  • Asking the executive to work with—or, if necessary, build—a coalition of other providers and community organizations that are also assisting individuals to shop for and buy insurance on the exchanges
  • Setting enrollment goals for each region and the system overall
  • Developing marketing pieces to support enrollment efforts

Setting Goals

In the most recent open-enrollment period, the entire system goal was 246,000 newly enrolled and re-enrolled exchange plan members. Each region had its own goal; for example, San Antonio’s goal was 141,000 patients, while the Texarkana region was shooting for 7,000.

“We want each region to enroll as many people as possible, but we want to be realistic about the numbers,” McNeil says. The potential market for exchange plan enrollment in each region is determined by identifying the overall number of uninsured individuals living in the counties in that region and the number of individuals who, by income, are eligible for tax credits to subsidize insurance premiums. The goal for each region is the sum of 30 percent of the potential market for tax credit eligible plus 90 percent of the pool of re-enrollees.

Measuring Success

CHRISTUS Health provides certain support, including a call center, to help individuals choose and enroll in a plan. The health system also reaches out to potential enrollees through direct-mail campaigns. Meanwhile, each CHRISTUS region works collaboratively with local organizations.

For example, the system provides enrollment assistors in each hospital for at least 10 hours per week, and regional executives are expected to take at least three actions per month to drive people to that assistance. Also, each region is responsible for placing at least one enrollment-related article in traditional or social media each month during the open-enrollment period. Articles can be about the open-enrollment process, the local coalition, enrollment events, or any topic that informs the public about exchange plan enrollment.

Each region is also responsible for tracking its enrollment progress using these metrics.

  • Number of people in the region who select an exchange plan, including all those enrolled by any coalition members, as well as all those in the region’s service area who have chosen a plan on their own
  • Number of people that members of an exchange coalition physically encounter/talk to about insurance in the enrollment period, excluding direct mail and e-mail
  • Number of small businesses a regional executive or a coalition will contact (multiple times if necessary) to offer enrollment information and assistance to their employees
  • Number of transfers  of potential enrollees the CHRISTUS call center makes to local assistors
  • Number of phone calls placed to the exchange phone number or exchange forms completed on the CHRISTUS website

See related tool: CHRISTUS Health Insurance Exchange Enrollment Goal Tracking Report

Assisting the Community

CHRISTUS Health’s outreach efforts to enroll patients in the health insurance exchanges has reduced the number of uninsured patients seen by the health system as well as attracted new patients. CHRISTUS’s coordinated regional efforts are giving patients access to healthcare services while improving the health system’s financial position.

Lola Butcher is a freelance writer and editor based in Missouri.

Interviewed for this article: Abby McNeil is system director of communications and public affairs. CHRISTUS Health, Irving, Texas.

Discussion Starters

Forum members: What do you think? Please share your thoughts in the comments section below.

  • How does your organization evaluate the success of its exchange enrollment efforts?
  • What has been your organization’s most successful exchange enrollment strategy?


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