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297960
Use of traditional patient navigation program strategies by Health Insurance Exchange navigator programs to reach, educate, and enroll at-risk/vulnerable populations in approved health insurance plans under the ACA
Monday, November 17, 2014
Joel M. Lee, DrPH
,
College of Public Health, University of Georgia, Athens, GA
Su-I. Hou, DrPH, CPH, MCHES, RN
,
Health Promotion and Behavior, University of Georgia, Athens, GA
Deborah Murray, EdD
,
College of Family and Consumer Sciences, University of Georgia, Athens,, GA
Curt Harris, Ph.D.
,
College of Public Health, Health Policy and Management, University of Georgia, Athens, GA
Background: Under the Affordable Care Act (ACA) at-risk/vulnerable populations have the opportunity to obtain health insurance coverage. However, it will be up to Health Insurance Exchange (HIE) navigator programs to identify those populations and perform the outreach, education and enrollment activities mandated by the ACA. To do so will require navigator programs to utilize strategies that successfully reach, educate and enroll at-risk/vulnerable individuals into approved health insurance plans. Methods: A qualitative research methodology was used to identify strategies used by traditional patient navigation programs (TPNPs) to reach, educate, and facilitate treatment for vulnerable populations. Studies were analyzed to determine whether improved outcomes were attributable to specific TPNP strategies. Strategies that positively contributed to improved outcomes as measured by study goals were considered successful, as were strategies that were consistent across TPNPs. Results: Findings showed that six strategies emerged that were pivotal in achieving maximum results. These strategies promoted the concepts of advocacy, bridging communication gaps, building trust, educating patients, and offering logistical and emotional support. Conclusions: Evidence has shown that certain TPNP strategies are successful in reaching at-risk/vulnerable groups and improving health outcomes. HIE navigator programs will guide the same at-risk/vulnerable populations as consumers in navigating an unfamiliar system of public health insurance. Using strategies found to be successful in reaching at risk/vulnerable groups has the potential to create successful HIE navigator programs and decrease the number of uninsured Americans. HIE navigator programs should consider using the same evidence based strategies to reach, educate, and enroll vulnerable populations into approved health plans.
Learning Areas:
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines
Learning Objectives:
Demonstrate the success of strategies used by traditional patient navigation programs to reach, educate and facilitate medical treatment for vulnerable populations resulting in improved health outcomes.
Describe how those same traditional strategies can be used successfully by HIE navigator programs to reach, educate and enroll vulnerable populations as consumers into state approved health insurance programs that could improve their health outcomes.
Keyword(s): Community Health Workers and Promoters, Health Insurance
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I serve as the public health program subject matter expert on the subject of the Affordable Care Act, have conducted health reform roundtables featuring state legislators, presented to county health officials on the challenges before local health departments in benefiting from health reform programs and activities, and researched this subject matter extensively as part of a doctoral dissertation.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
