Points of Impact: Minal Patel, Ph.D., M.P.H.

In today’s rapidly changing healthcare landscape, navigating the complex web of health insurance options can be daunting and complicated. This is particularly true for those who are uninsured or may have limited experience with the healthcare system. Many people don’t know where to begin looking for trustworthy information about health insurance or assistance with enrollment, or how to utilize coverage they may already have. Many aren’t even aware that they’re eligible.

A new website called Insuring Good Health, developed through a collaboration between U-M and Detroit-area community organizations and health centers, is helping to break through some of the common barriers to accessing coverage, particularly among communities that have historically been marginalized when it comes to access to health insurance.

Minal Patel, Ph.D., M.P.H., John G. Searle Assistant Professor of Health Behavior & Health Education at the University of Michigan School of Public Health, discusses how the new website is being used to build awareness, knowledge, and confidence about health insurance options, and encourage new connections to healthcare resources.

Q: Why is there a crucial need for a resource like this?

Since the Affordable Care Act, there’s been a lot of outreach focused on getting people enrolled in health insurance. The uninsured rate has hit a record low, but insurance gaps persist within minority communities. These are the people who tend to remain uninsured, or go off and on insurance, and they can be the hardest to connect with because of language barriers, mistrust of institutions, and a number of other reasons. This is particularly true in Detroit, where we’ve been seeing communities with large numbers of uninsured people, even in areas where enrollment assistance was available. Many community-based agencies in Detroit have specialists available to help with enrollment, but people are not often aware this assistance is available to them, or don’t seek it out. So based on the data and our conversations with community organizations, we saw the need to do more specific and tailored outreach to connect people to actionable information and community resources.

Q: There are a lot of common misconceptions about health insurance – how does Insuring Good Health address those?

We know that among people who are eligible for insurance, many remain uninsured for a variety of reasons, including perceptions about costs, not being aware of what’s included in the ACA provisions, and low health insurance literacy.

We’re promoting several key messages to help people to make the most of the options available to them, such as:

• Even recent immigrants to the U.S. can get health insurance.
• If you lose your job, you might also lose your health insurance – but there are many options to get health insurance outside of employment.
• If you already have an illness or injury, health insurance can help you cover the cost.
• You may qualify for Medicaid coverage even if you did not in the past.
• If seeing your current doctor is not working for you, an enrollment assister can help you find a new one.
• Getting health insurance can help prevent trips to the emergency room and large bills.

All of this information was developed using evidence-based behavior change principles and best practices around health communication and plain language, and presented with character-driven storytelling – in this case, through relatable superheroes who also happen to experience the same health and financial issues as regular people. The website and the videos it includes have been developed in English, Spanish, and Arabic.

Q: How are the website and accompanying videos designed to be used?

Although Insuring Good Health was developed in Detroit, the information can assist anyone in the U.S. looking for insurance options. People may visit the website on their own, or review the content in conjunction with navigator services. The website is adaptable to a computer, smartphone, or tablet. A community-based agency might use it to inform people and help them prepare questions for when they do see an in-person navigator. Because navigators are very busy, and there have been a lot of funding cuts with the ACA around outreach, organizations may not have the resources to reach as many folks as they’d like, so social service agencies, community clinics, and healthcare delivery systems can use it in creative ways to reach populations that they work with.

We’ve also developed a comprehensive set of outreach tools that organizations can use to promote the site, including a full component of customizable social media tools, handouts, and stickers to motivate people to seek out assistance and know where to find it. Organizations can also request the videos separate from the website to show in waiting rooms. We want more people to seek out assistance whether it’s an in-person navigator, calling their insurance company, or following up with Medicaid – above all, just sticking with the process. It’s one thing to get enrolled in insurance – but you also have to maintain it. The central message is that you don’t have to do it alone! We hope this site and the experiences of the characters motivate people to seek help when they need it to navigate or even change their options.

Q: How will the website adapt to changes to the ACA and Medicaid?

Changes are inevitable, and we update our site along with them, by highlighting changes in policy that may affect insurance coverage options, or displaying alerts about particular information that may be prominent in the news and people may have questions about. There’ve been plenty of changes since we started working on this project, which was right as Medicaid eligibility expanded in Michigan. We could have just made an educational website, but with the ever-evolving information around health insurance, we felt the best solution was to take this to the next level by making links to the dedicated people in the community who can assist people, and help start those conversations.

Visit Insuring Good Health

Access the set of outreach tools and evaluation report

Insuring Good Health was created by the Insure Detroit Partnership, a collaboration between the University of Michigan and several Detroit-area community organizations and health centers. The Insure Detroit Partnership is an affiliated partnership of the Detroit Community-Academic Urban Research Center. Funding for Insure Detroit was provided by the National Institute for Health Care Reform (NIHCR).