Impact of Outreach on Medicaid Enrollment

Study Overview
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Brief Summary
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This project will assess the impact of various forms of outreach from navigators on Medicaid enrollment. Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The investigators propose to randomize the nature of outreach to households in Wisconsin enrolled in fee-for-service Medicaid who must renew or lose their coverage.

Detailed Description
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During the COVID-19 public health emergency, states received support to maintain continuous Medicaid coverage, raising Medicaid enrollment to unprecedented levels. In Wisconsin, enrollment was nearly 30% higher by the end of 2021 compared to February 2020, with the maintenance of enrollment policy contributing to much of this increase. After the end of the public health emergency, normal renewal processes will resume. The Wisconsin navigator program, Covering Wisconsin, has been commissioned by the Department of Health Services (DHS) to conduct outreach to the group of fee-for-service Medicaid beneficiaries who need to re-determine eligibility after the conclusion of the public health emergency. To identify what outreach strategies are most effective, the investigators propose to randomize the nature of outreach used. While there will be some variation in the content and timing of messages, all beneficiaries will receive messages with clear information on how to contact the navigators.

Official Title
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Outreach and Maintenance of Medicaid Enrollment: Evidence From Wisconsin's Navigator Program

Conditions
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Health Insurance

Intervention / Treatment
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* Other: Outreach From Navigators


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Included on the lists Wisconsin DHS provides to Covering Wisconsin of fee-for-service Medicaid beneficiaries who need to renew their Medicaid coverage Exclusion Criteria: Prefer a language other than English or Spanish or lack a cellular phone number
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The nature of the intervention will be randomized to participants.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Outreach via Postcard<br>40 percent of the sample | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Postcard + Outbound Call<br>Outreach via postcard, plus placed an outbound phone call from navigators (20% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Call to Hotline<br>Outreach via text message encouraging a call to a hotline for assistance (15% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Call to Hotline + Outbound Call<br>Outreach via text message encouraging a call to a hotline for assistance, plus outbound phone call from navigators (7.5% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Text Reply To Connect with Navigators<br>Outreach via text message encouraging a text reply to connect with navigators via chatbot (15% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Text Reply To Connect with Navigators + Outbound Call<br>Outreach via text message encouraging a text reply to connect with navigators via chatbot, plus an outbound phone call from navigators (7.5% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging a Call to a Hotline for Assistance + a Reminder Message<br>Outreach via text message encouraging a call to a hotline for assistance plus a similar reminder message two weeks later (15% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach Text Message Encouraging Call a Hotline for Assistance + Reminder Message<br>Outreach via text message encouraging a call to a hotline for assistance plus a similar reminder message two weeks later + outbound call (7.5% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Text Reply To Connect with Navigators+ a Reminder Message<br>Outreach via text message encouraging a text reply to connect with navigators via chatbot plus a similar reminder message two weeks later (15% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|
| Experimental: Outreach via Text Message Encouraging Reply To Connect with Navigators + Reminder Message<br>Outreach via text message encouraging a text reply to connect with navigators via chatbot plus a similar reminder message two weeks later + outbound call (7.5% of sample) | Other: Outreach From Navigators<br>* Navigators are professionals who can provide one-on-one assistance with the Medicaid renewal process. The nature of the outreach will be randomized to participants.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Who Renew Medicaid Coverage |  | up to 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Outreach, Enrollment, Medicaid