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OpenTrials
Enrolling by Invitation

NCT Number: NCT06709794

Evaluating the Effect of Automatic Plan Assignment and Enhanced Outreach of Marketplace Take-up

Facilitated enrollment offers a potential solution to some administrative burdens and choice frictions that may produce incomplete take-up of marketplace coverage. Because Covered California, California's ACA individual marketplace, and Medi-Cal, California's Medicaid program, share an eligibility system, Covered California has the ability to identify individuals who are eligible for marketplace coverage upon losing Medicaid eligibility.

This evaluation will compare the effectiveness of facilitated enrollment strategies, including personalized plan pre-selection and personalized quotes of net premiums, to other enhanced, but general outreach tactics, on marketplace take-up among individuals losing Medi-Cal coverage.

Enrolling by Invitation

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Key information

Conditions

Outreach Intervention

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Covered California

Sacramento, California, 95620, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Individual in a single-member household
  • Discontinued from Medi-Cal
  • Eligible for Covered California program
  • Ineligible for APTCs on initial application
  • Did not attest to planning to file taxes within their Covered California application

Exclusion criteria

  • Consumer case is no longer active within the application system
  • Consumer is already actively enrolled in a marketplace plan
  • Consumer has already restored Medi-Cal eligibility
  • A consumer's Special Enrollment Period has ended
  • Consumer is no longer listed as a single-member household
  • Consumer was procedurally denied from Medi-Cal coverage due to no response
  • Consumers has a MAGI Medi-Cal income less than 138% of the Federal Poverty Level (FPL)

Treatment and study plan

Informational flyer

Behavioral

In addition to a standard eligibility notice informing participants of their eligibility for marketplace coverage, they receive an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays

Modified eligibility notice with plan information

Behavioral

a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount in addition to the informational flyer and instead of a standard eligibility notice

Primary outcomes

  1. Enrollment

    Time frame: within calendar year since the loss of Medicaid

    a binary indicator for whether a consumer has at least one month of effectuated coverage a Covered California plan that started within the 90 days of their Special Enrollment Period (SEP) following loss of Medi-Cal coverage

Secondary outcomes

  1. Tenure

    Time frame: within 1-2 years after treatment assignment

    Tenure with Covered California (measured in months)

  2. Uninsured

    Time frame: within 1-2 years from the treatment assignment

    A binary indicator for whether someone self-reported being uninsured while filing their taxes;

  3. Consumer engagement

    Time frame: within 90 days from the treatment assignment

    A binary indicator for consumer engagement including calls to service center, creation of and logins to user account, plan shopping on the website, agent delegation after eligibility determination;

  4. Office visit

    Time frame: during 1-2 years since the treatment assignment

    A binary indicator for whether someone had an office visit to the medical practitioner during 1-2 years since the intervention;

  5. Prescription filled

    Time frame: during 1-2 years since the treatment assignment

    A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention;

  6. Emergency room visit

    Time frame: during 1-2 years since the treatment assignment

    A binary indicator for whether someone had an emergency room or department visit during 1-2 years since the intervention

  7. Hospital admission

    Time frame: 1-2 years before and during 1-2 years after the treatment assignment

    A binary indicator for whether someone had a hospital admission 1-2 years before and during 1-2 years since the intervention

  8. Out-of-pocket health care spending

    Time frame: during 1-2 years since the treatment assignment

    Total out-of-pocket spending for the 1-2 years since the intervention

Sponsors and collaborators

Lead sponsor

Covered California

Other Gov

Registry information

Acronym: MAPS

Important dates

Study start
2024
Primary completion
2026
Study completion
2028
First posted
Nov 29, 2024
Registry last updated
Nov 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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