Marketing

What behavior change interventions have been implemented with regard to this behavior?
The behavior change targeted by the following outreach strategy is to increase community empowerment to enroll in Medicaid.

Describe the interventions
This intervention is designed to target Medicaid and CHIP eligible by implementing a number of advertising campaigns, across varied media, simultaneously to support and encourage enrollment. Although specific details varied from state to state, all outreach strategies contained five distinct components:

  • Advertising – any non-personal communication, usually including mass media, targeted at large populations
  • Person-to-person contact – personal contact with a knowledgeable party where the message is tailored to individual needs
  • Direct Marketing – Direct mail, phone hotlines, telemarketing, websites, etc.
  • Promotions – Incentive programs designed to improve uptake, including coupons, contests, value enhancing
  • Public Relations and publicity – designed to improve public understanding and acceptance through a positive image; includes events, sponsorship, public affairs activities, etc

States that implemented advertising campaigns tended to use three or more different media outlets to access the largest population. The most common media were television and radio ads, public service announcements, and brochures. One state, New Jersey, reported advertising Medicaid and CHIP programs on milk cartons. To further broaden the target population, advertisements were also broadcast in multiple languages. Direct marketing campaigns were popular among states and included mail advertising, hotlines, and websites. Other promotional campaigns included branded merchandise to improve program awareness (T-shirts, Frisbees, gym bags).

Across all states polled, interventions could be categorized into three distinct approaches:

  • Community-based outreach
  • Public health or government-based outreach
  • Youth or adult events

In community-based outreach programs states develop relationships with prominent community organizations like churches, community centers, employers, and schools to increase Medicaid eligibility awareness. States dispatch enrollment specialists as outreach representatives to support community-based outreach programs through these organizations. In some examples, representatives travel through the community conducting face-to-face interviews with eligible or recently unenrolled people. These community organizations, which support large unenrolled eligible populations, also serve as bases for speeches, public forums, and other door-to-door programs. Similar to community-based outreach public health and youth event outreach programs leverage existing public health infrastructure in the community. Existing resources are supplemented with government outreach personnel to support outreach, and may staff events targeted at young people like fairs, tax free shopping days, and school immunization days. Overall, these three approaches focus on a personalized, face-to-face approach to encourage enrollment.

Describe groups that have benefited from the various evidence-based intervention
The Medicaid and CHIP eligible population is large and diverse, and few states actively pursued or tracked strong metrics for tracking enrollment in specific communities. Colorado implemented origin codes with applications to attempt to pinpoint communities most benefitted by outreach programs. Other states contracted researchers to conduct effectiveness studies. Due to this gap in data, most states relied on total enrollment changes during outreach periods as a general predictor of effectiveness. Arizona total enrollment increased from 7.03% to 25.91% from 1998 to 2000, and similarly successful states increased total enrollment by approximately 10%. CHIP enrollment increased almost universally across all states in the study.

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