COVID-19 �Public Health Emergency

Unwind Planning

Community Partners

July 26, 2023

Marivel Klueckman | Eligibility Division Director, HCPF

Alison Ledden|PHE Communications Specialist, HCPF

Lisa Pera|Deputy Eligibility Division Director, HCPF

Rachel Reiter | Policy, Communication & Administration Office Director, HCPF

Ezra Watland | Marketing & Communication Director, Connect for Health Colorado

About this webinar

Will this presentation be shared?

Yes. A recording of this meeting and the slide deck will both be posted on the PHE Planning webpage in a few days.�

Will all of your questions be answered?

We will have time for questions at the end of the data section. We have a team of staff answering questions put into the Q/A throughout the presentation, but we may not get to all of them. Frequently asked questions will be added to the FAQs in the PHE Planning webpage. Question themes from prior meetings are already posted.�

https://hcpf.colorado.gov/covid-19-public-health-emergency-faqs

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Today’s Agenda

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1. Helping Get the Word Out: New Outreach Materials
2. Policy Strategies for the Unwind: Overview of Colorado’s Flexibilities
3. Early Data: Continuous Coverage May Cohort Reporting Details
4. Break for Questions
5. Refining Our Outreach
1. Focus Populations
2. Reaching those who are transitioning to other coverage (Connect for Health Colorado)
6. Wrap Up & Future Meetings

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Helping Get the Word Out

�New Resources & Partnerships

Alison Ledden, HCPF

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Renewal Cycle Member

Direct-to-Member Communications Overview

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Member remains on HFC or moves to CHP+

Member receives renewal notice

Member submits renewal packet

Member transitions to other coverage

Initial Renewal Outreach: Time to Renew! 

HCPF sends renewal packet, email, text, push notification via Health First Colorado app to members

Reminder Outreach:  Take Action Now

HCPF (via Enrollment Broker) sends letter to those who have NOT taken action

RAEs/CHP+ plans  & CMAs outreach to all members, especially their high risk and/or focus populations, who have not taken action (email, text, phone, letter)

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Transition Outreach:

HCPF sends letter directing to Connect for Health (C4H)  exchange plan options where appropriate

C4H does direct outreach

Ongoing broad outreach: HFC website, traditional & social media, HFC app, PEAK, member newsletters, call centers, partner & provider messaging, case managers, posters/flyer materials in libraries, homeless shelters, clinics, PSA campaign.

Increasing Awareness:

We need your help!

Print and hang flyers in public areas to increase member awareness

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Take Action Toolkit/flyers

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Keep CO Kids Covered/flyers

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New Employer Flyers

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HCPF connecting with Employers & Associations to raise awareness

• How Colorado Employers Can Help Employees Navigate Medicaid Renewals & Transitions to other coverage

#KeepCOCovered Toolkit

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Transcreation of Materials

Materials in the following campaigns will be transcreated into the top 11 languages spoken by members: Amharic, Arabic, Burmese, Chinese, Dari, Pashto, Russian, Somali, Swahili, Ukrainian, and Vietnamese

Coming Soon (by end of July)

• Take Action on Your Renewal
• Keep CO Covered

Note: Scam messaging is being updated & transcreated materials will follow suit later in July

Scam Alert

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Helpful App & PEAK Features

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Health First Colorado App

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• Report more detailed income and assets info and easily upload related documents.
• Opt-in to push notifications that give them status updates on document submissions and important communications re: their benefits
• See their renewal date on the opening screen.

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PEAK

• Renewal Button 60 days in advance of a member’s renewal date
• When the members submits their renewal it will show as "submitted" in the dashboard
• Reminder of the 90 day reconsideration period

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• Have you used our toolkits in the last 30 days?�
• Which toolkit materials have been most effective in your outreach efforts?

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Poll Questions:

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Policy Strategies for the Unwind: Overview of Colorado’s Flexibilities

Marivel Klueckman, HCPF

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Flexibilities Colorado is Leveraging

Unhoused Flexibility

• Renew Medicaid eligibility for individuals with no income and no data returned on an ex parte basis ($0 income strategy)

Streamlining Income Determinations

• Renew Medicaid eligibility based on financial findings from the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF)

Premium Resumption Delay

• Delay the resumption of Medicaid premiums otherwise approved under the state plan for members throughout Colorado’s 12 month unwind phase

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CMS Strategies and Flexibilities

• HCPF reviewed the June 2023 strategies presented and considered system updates and timeframes for implementation
• exploring the ‘at or below 100% FPL’ strategy
• Customized CO implemented strategies to address the goal of mitigating procedural terminations
• Intelligent Character Recognition (ICR) to identify received renewals and start in eligibility system
• Continuous ex parte system enhancements
• Reformatting of the renewal packet in October 2023

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*June 2023 CMS Strategies: https://www.medicaid.gov/resources-for-states/downloads/state-strategies-to-prevent-procedural-terminations.pdf

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Consolidated Return Mail Center (CRMC)

“Prowers County Consolidated Return Mail Center is dedicated to delivering effective and efficient address data with integrity and accountability using innovative methods to assist the State of Colorado.”

Consolidated Returned Mail Center

Consolidated Returned Mail Center Making an Impact:

70% members being found

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Early Data:

Continuous Coverage

May Cohort Reporting

Rachel Reiter, HCPF

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Visit our NEW Reporting Page!

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• Historical context from pre-pandemic renewals
• Monthly point in time data reports
• Links to the slides from this webinar with demographic breakouts
• Overview of reporting elements and what they mean
• FAQs and more…

May Data: A Snapshot

• First month of regular renewals - too early for trends.
• Members have additional 90 days to return packets
• May data pulled on June 26 matches pre-pandemic rates: �56% renewed - estimated 57% pre-pandemic
• 42% disenrolled - 41% pre-pandemic
• Of those disenrolled, procedural denials were 26% - 12% pre-pandemic
• Only 3% voluntarily disenrolled - should be higher given our outstanding unemployment rate

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56% of May cohort were renewed for coverage

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NOTE: 90 day reconsideration period means others denied may come back onto coverage AFTER responding.

Top Eligibility Denial Reasons -

Majority Over Income (60%)

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NOTE: CMS data reporting includes all eligibility denials within “sent to marketplace”. The marketplace is prioritizing outreach to certain denial reasons.

First month of data (snapshot)

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Outreach Opportunities

Based on pre-pandemic data, on average about half of those losing coverage become eligible for Medicaid again within two years.

Deeper Dive:

Overall Enrollment

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Overall Enrollment

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NOTE: Total enrollment is the net enrollment, includes those rolling off coverage, NEW applications and those who have regained coverage by completing renewals after deadline but during the 90 day reconsideration period.

Enrollment by Age

Distributions Remain Consistent

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Kids Enrollment:

% CHP+ up 0.2%, Medicaid down same

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Regional Composition

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Racial Composition - Distributions Remain Consistent

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Questions?

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Deeper Dive:

Snapshot in Time of

May Renewal Cohort

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Lisa Pera, HCPF

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May Cohort:

Renewed by Race

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Before Renewals

(Enrollment May 2023)

0.9%

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2.5%

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6.9%

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31.7%

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0.4%

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7.4%

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5.2%

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5.0%

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40.0%

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May Cohort: Renewals by Region

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Urban/Metro 87.9% Rural 7.8% Frontier 4.3%

Before Renewals

May Cohort: Renewals by Age

Breakout data from Brian

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Before Renewals

65+ 6.2% 19-64 60.6% 18 and under 33.2%

What We Are Hearing - LTSS

• Renewal packets can take longer to complete and process, and may require more documentation
• HELP encourage this population to take action early!
• Members can still complete the renewal without having to reapply during the 90-day reconsideration period

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What We Are Hearing - Kids

• Kids can still qualify even if parents do not
• HELP us encourage parents to still apply to see if their kids qualify
• Buy-In Program for Kids with Disabilities has higher income thresholds, different rules
• Back to School Campaigns & Partnerships

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May Cohort:

Other Known Commercial Coverage

Breakout data from Brian

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NOTE: You can have other coverage and still qualify for Health First Colorado. The above excludes Medicare.

Early Insights - Other Coverage

• Colorado’s strong economy could mean more have employer sponsored or other coverage
• Of those rolling off coverage in May - 13% of eligibility and 14% procedural denials had other known sources of commercial coverage
• Investigating ways to further target limited resources to those that still need coverage

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Questions?

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Poll Question 3: Were these type of data breakouts helpful?

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Refining Our Outreach: Targeted Outreach Strategies

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Alison Ledden, HCPF

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May 2023

Outreach Metrics

Direct outreach to ~65,000 households up for renewal via CBMS

Notices mailed 3/16; received 2-3 days later

~21,500 auto renewed via ex parte (runs March 12-15)

~43,500 packets sent by mail or PEAK after 3/16, received 3/20-24

Follow-up Outreach (outside of CBMS)

SMS Texts

35,175* sent / 43,500

28,150 EN (88% delivery)

7,025 SP (90% delivery)

Emails

11,205* sent / 43,500

10,917 EN (98.4% delivery)

288 SP (96.2% delivery)

Enrollment Broker Letter

(members who have not signed up for digital comms)

8,233 Letters Mailed

to members who needed to take action on renewal

General Awareness | Member newsletter, HCPF & HFC websites

• >125k member newsletters in April & May | >45% opened
• >2600 members reminded of their renewal date via the Member Call Center in May
• >25k unique visitors to new HFC Renewals page since its creation in December 2022
• >300K unique visitors to HFC.com past 90 days | 83% higher than 2022 same period
• >114K Household Addresses updated in PEAK since April 2022

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*Emails & Texts only sent to those for whom we have info on file & have opted in (email)

Increasing Renewal Responses & Updating Contact Information: Outreach to Focus Populations

Collaboration with sister agencies to increase awareness

• Unhoused (CDHS, DOLA, Clinics)
• Kids & Families (SHS, FAMLI portals, Food Banks, WIC, Libraries, Rec Centers)
• Young Adults (CDHE to reach college students)
• Seniors and Veterans (DOI & DVA)
• Tribes
• Health professionals (DORA) - 230,000 emails sent

Collaboration with Health Plans

• Providers, CMAs

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Survey: Share Your Ideas, Take Our Survey!

• If you are currently doing outreach, what is working well? What can be improved?
• What are key community partners not currently engaged who can help get the word out to focus populations?
• What are additional tactics you would recommend for your community?
• Survey Link

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Focus Population: Supporting Transitions in Coverage

Connect for Health Colorado

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Ezra Watland, Connect for Health CO

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Connect for Health Colorado Emails to Potential Customers

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Example from last Open Enrollment

Colorful, eye-catching and friendly branding

Simple language and short emails

Links and graphics to learn more and get help

Ongoing activities to support awareness

Direct Outreach�

• Notice of Action: Sent by HCPF
• Joint Letter: From HCPF and C4 to customers who prefer mail
• Email marketing: 1 email sent to everyone with an email address
• Outbound calls: Prioritize those without emails
• Follow-up calls: Customers who started an application and haven't completed the process

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Indirect Outreach�

• Social media: Utilizing messages from the HCPF toolkit each week

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• Earned media: Pre-Unwind activities as well as additional press activities in May/June

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• Stakeholder Newsletters: Shared with existing lists across the state (ex DHS, with a 10,000 member list)

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• HCPF PSA campaign - Running through End of Year

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Stay informed

• Bookmark the Unwind Data Reporting Page
• Sign up for the monthly COVID-19/PHE Updates Newsletter
• Visit the PHE Planning Resource Center for resources:
• Download, print & hang up flyers in common areas
• Share messaging on your websites and in your newsletters
• Share social media messaging and graphics
• Sign up for the next Community Partner PHE Unwind Planning Webinar
• October 25, 2023 1:00-2:30pm Register in advance

Contact Info

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Marivel Klueckman

Eligibility Division Director, HCPF

marivel.klueckman@state.co.us

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Rachel Reiter

PCA Office Director, HCPF

Rachel.Reiter@state.co.us

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Alison Ledden

PHE Communications Specialist, HCPF

Alison.Ledden@state.co.us�

Ezra Watland

Marketing & Communication Director

Connect for Health Colorado

ewatland@c4hco.com�

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Thank You!

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Alternative versions of cohort data slides

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May Cohort:

Renewed by Region

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Urban/Metro 87.9% Rural 7.8% Frontier 4.3%

Before Renewals

3.3%

May Cohort:

No Longer Eligible by Region

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Urban/Metro 87.9% Rural 7.8% Frontier 4.3%

Before Renewals

4.6%

3.6%

May Cohort: Renewed by Age

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Before Renewals

65+ 6.2% 19-64 60.6% 18 and under 33.2%

1.5%

May Cohort: No Longer Eligible by Age

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Before Renewals

65+ 6.2% 19-64 60.6% 18 and under 33.2%

7.6%