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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 15: Adequate Insurance Coverage

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child and father holding a paper cutout of a houseInsurance Enrollment Helpline

MCH Strategy. Maintain a state-run helpline to assist with insurance enrollment navigation.

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Overview. Community‐based case managers who provide health insurance information, support filling out applications, and negotiate with the insurer appear to increase enrollment of children in health insurance programs.1

Evidence. Moderate Evidence. Insurance enrollment helplines have shown to be effective. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Patients.

Outcome. Percent of children ages 0-17 who are adequately insured. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 4 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the strategy “Maintain a state-run helpline to assist with insurance enrollment navigation,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of calls to the helpline per month.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of uninsured individuals who utilize state-run helpline per month.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of calls to helpline per month that result in successful insurance coverage enrollment as reported by caller in 3 month follow-up survey.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of calls to helpline per month that result in successful insurance coverage enrollment as reported by caller in 3 month follow-up survey.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1Jia et al. (2014). Strategies for Expanding Health Insurance Coverage in Vulnerable Populations. Cochrane Database Systemic Review.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.