TexCare Partnership Outreach:
A Vision for Next Steps

Rationale

TexCare Partnership (TCP) outreach efforts are well on their way to reaching the "start-up" phase goal of enrolling 428,000 children into the Children's Health Insurance Program (CHIP) by September 1, 2001. In addition, thousands of children reached by TCP outreach efforts are now receiving health care services in the Medicaid program. Much of the credit goes to the thousands of local outreach staff and volunteers who have worked tirelessly in every county in the state to reach families with children who need health care coverage, as well as to effective advertising efforts that have reached families with the good news about accessible coverage.

Outreach in the first year and a half of TCP focused on a call-to-action to families to call the TCP hotline or send in a written application; direct application assistance by local outreach staff; and mass dissemination of information about the program. These strategies were appropriate for the "start-up" phase, as the challenge was to reach hundreds of thousands of unidentified families eligible for children's health insurance.

TCP has always been designed to outreach on behalf of both Medicaid and CHIP. However, because CHIP was a new and separately financed program that offered the first-ever opportunity of coverage to hundreds of thousands of families, much of the focus of state and local stakeholders has been on assuring the achievement of the ambitious CHIP "start-up" goal. Now that CHIP has been successfully launched, we are enter a new outreach phase that will be dominated by the need to promote renewal and appropriate utilization of services and by the implementation of SB 43. This legislation will benefit many families because it mandates an application and enrollment process for Medicaid-eligible families as seamless, simple and transparent as that enjoyed by CHIP-eligible families.

We can be certain that SB 43 implementation will assure not only continued promotion of both Medicaid and CHIP through TexCare Partnership, but an emphasis on publicizing the changes in the Medicaid process as well. We also know that:

• TCP has not reached all children eligible for CHIP or Medicaid. We still need to reach the estimated 500,000 children eligible for Medicaid, and 200,000 eligible for CHIP.
• 340,000 babies are born in Texas every year, many into families without access to health insurance;
• thousands of families move into the state who have no children's health insurance; and
• families will continue to lose their insurance coverage through job changes or economic dislocation.

For these reasons, TCP can never stop the call-to-action outreach efforts that have been so effective in the first phase of the program. But, these activities now need to be diversified and strategic as our focus shifts to include the permanent incorporation of TCP information into other systems in the community and the perpetuation and appropriate utilization of existing coverage.

Process to Develop the Outreach Vision

In June, HHSC published and widely distributed a draft of this vision paper to stakeholders and the public. Several commenters expressed their concerns about the accessibility of health care services and emphasized that the state needed to attend to access as much as outreach in the program. Others offered suggestions about specific aspects of implementation and outreach contractor deliverables. But in general, there were no stakeholders who disagreed with the general parameters presented in the draft vision paper.

Next steps in developing specificity of TCP outreach plans will depend on several developments, including recommendations that will come out of the SB 43 implementation process. HHSC also is in the process of re-procuring the TCP marketing/media contract. Once the contractor has been hired, this firm will conduct a new round of consumer research January through May of 2002. Updated mass communication messages will be developed, based on the results of that research. Also, new core outreach materials will be developed that will take into account the analysis of program data, Texas consumer research results, national research where appropriate, the experience of other states such as California and Florida, stakeholder input, and a needs assessment of TCP contractors (CBOs and health plans) conducted by the state and the marketing/media contractor.

Vision

In all aspects of implementing TCP, Texas has learned from the experience of other states. A review of that experience suggests that a broadening of strategy is appropriate at this time. By not placing so much emphasis on mass information dissemination and direct application assistance, the program will benefit from:

• increasing the efficiency of efforts to identify and target under-served populations;
• broadening and incorporating automatic information dissemination systems within organizations that have frequent contact with families;
• increasing the emphasis on all aspects of disease and disability prevention;
• communicating that, through TCP, families can afford to keep their children healthy and protected in the event of illness; and
• emphasizing family maintenance of health care coverage and appropriate utilization of services.

Other states' experience also shows that the program and the enrolled children benefit when efforts are made to keep enrolled children in health care coverage when their first period of eligibility expires.

Based on this experience, the state proposes the following goals for the next phase of outreach for TCP:

• adoption of a long-term, integrated communication plan that includes coordinated community-based and statewide initiatives;
• an appropriate level of call-to-action through broad appeals and mass communications to reach eligible families;
• mass media messages and activities by outreach contractors and health plans shifting primary emphasis from a call-to-action to the idea that through TCP, families can afford to keep their children healthy and protected in the event of illness;
• increased emphasis on activities by outreach contractors and stakeholders to place TCP information in the hands of families at times and places in which they are likely to be motivated by and interested in the information;
• activities by outreach contractors and stakeholders to work within organizations that have regular contact with families, i.e., emergency rooms, provider offices, pharmacies, schools, new employee orientation at businesses, etc., to set in place automatic and recurring "systems" to inform families and help them apply for health care coverage through TCP; and
• continued activities to support enrollee families in successfully completing their annual renewal process, involving health plans, the administrative services contractor, and CBOs.

Conclusion

As the Texcare Partnership campaign to insure Texas children prepares to enter its second year, outreach remains critical to the effort's success. As before, the success of the campaign will require the commitment of entire communities across the state of Texas.

Outreach now will become more strategic in nature as we seek to work with entities in all sectors of the community to broaden the message to include the value of insurance, the importance of renewal and education on appropriate utilization of services.

This page last updated: 01/24/2005