Going Grassroots: How Swedish Covenant Hospital is Encouraging Exchange Enrollment

Swedish Covenant Hospital reaches out to the community to help the uninsured get coverage.

SCH Logo Centered SCHBlue notaglineDeciding which health plan to enroll in can be a difficult experience for people without an understanding of how insurance works. Therefore, Mark Newton, CEO of Swedish Covenant Hospital in Chicago, says it's not enough to simply create the opportunity for the uninsured to get coverage under the Patient Protection and Affordable Care Act.

"It's one thing for the government to put together a structure for access, and it's another to actually deliver it," he says. "From just a standpoint of justice for the patient, it would be a sad commentary if people had available access but didn't know how to act on it."

To make sure people in the Chicago area don't miss out on this opportunity to get health insurance, Swedish Covenant has launched additional community engagement efforts, reaching out to leaders within its service area to help educate the public on the healthcare reform law and encourage enrollment, an initiative that benefits both patients and the hospital.

Enrollment in Illinois and how Swedish Covenant is helping
Illinois officials have predicted more than 1 million uninsured state residents will gain coverage in 2014 under the reform law. That includes about 200,000 to 300,000 who were expected to select coverage through the state's health insurance marketplace (a state-federal partnership) and 500,000 to 800,000 who would become eligible for coverage under the Illinois Medicaid program, which the state opted to expand in 2014 to cover those earning up to 138 percent of the federal poverty level.

According to HHS, as of Dec. 28, 61,111 people had selected a marketplace plan in Illinois. 

Since early 2013, Swedish Covenant has been working to boost enrollment in the state. Hospital liaisons have met with more than 50 leaders and have hosted educational events. They have worked with Chicago groups, including the Cambodian Association, Korean American Community Services and Heartland Health Services, to support them in becoming navigators, organizations that assist people in signing up for coverage under the PPACA.

"Our overall approach was to address the healthcare literacy gap with a grassroots effort," says Mr. Newton.

Additionally, the hospital has trained all 20 of its credit service representatives as certified application counselors who review the self-pay cases and man a call center to help uninsured consumers understand their health insurance options.

The CACs speak 10 different languages, in line with Swedish Covenant's diverse service area population, according to Nick Przybyciel, the hospital's public relations manager. From Jan. 2 to Jan. 8 alone, the counselors referred 117 self-pay patients to the state's expanded Medicaid program and successfully enrolled 40 of them in Medicaid coverage.

Benefits for Swedish Covenant and the uninsured
By engaging with the community to make sure people are well-informed about their coverage and care options, Mr. Newton says his hospital can ensure the uninsured not only get health insurance but also know where to go for the care they need, rather than initially just going to the emergency room for treatment.

Other than helping patients by aiding them in getting coverage and proper care, Mr. Newton says educating uninsured community members and getting them enrolled in health plans helps Swedish Covenant as a disproportionate share hospital, a designation that indicates it treats large volumes of low-income patients. Getting people enrolled in private health insurance or Medicaid improves the hospital's ability to identify the low-income percentage of its patient population.

"It's important for us to provide evidence of low-income patients served," he says. "That can affect us on disproportionate share payments."

Overall, Mr. Newton emphasizes that a grassroots approach has been key to the success of Swedish Covenant's outreach efforts.

"Using the grassroots strategy is one that's been very beneficial for us, and it's done in a very respectful way," he says. "These are often very individualized and very personal kinds of decisions that people make.  "Using a broadcast strategy is just not going to penetrate their consciousness enough."

More Articles  on PPACA Enrollment:
3 Key Findings on Consumer Health Plan Choices on PPACA Exchanges
4 Early Observations on PPACA Enrollment
HHS: 6M Have Gained Coverage Through PPACA 

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