NMHIX, local health orgs adapting to abbreviated exchange enrollment timeline

December 5, 2013 • Local News

Outreach worker for La Casa Family Health Center Alice Palma-Aarmendariz helps a couple sign their family up for Medicaid during her third of four enrollment appointments Wednesday. (Tess Townsend Photo)

The New Mexico Health Insurance Exchange (NMHIX) and local health care organizations are racing to adapt to an abbreviated window of time to enroll patients in insurance plans offered on the federal health insurance exchange for individuals.

The exchange [auth] website was virtually out-of-service until the federal government made alterations to it last weekend. The fixes mean increased capacity for enrollment through the site, but their timing leaves only three months until the March 31 deadline for the exchange’s open enrollment period, as opposed to the six-month window originally slated.

The exchange, which was established under the Affordable Care Act, offers subsidized health plans to patients who make between 138 and 400 percent of the federal poverty line. New Mexico currently runs on the federal exchange, but will adopt its own exchange within the next year. NMHIX will run the state exchange.

La Casa Family Health Center, which has locations in Chaves, Roosevelt, Curry and Lincoln Counties, may temporarily open on Saturdays to accommodate enrollment demand, according to David Briseno, director of outreach for the community health clinic organization.

“I don’t want to overwork our folks, but we want to provide a quality service to the people we are serving,” he said.

Outreach workers at La Casa are already facing a high volume of enrollment appointments. The organization as a whole has six Health Care Guides, two of which are in Roswell.

New Mexico’s guides are certified through the state Office of the Superintendent of Insurance to enroll patients in exchange plans and conduct outreach regarding health care reform. They differ from insurance brokers in that they are not permitted to promote one exchange plan over another.

Alice Palma-Aarmendariz, an outreach worker for La Casa, said that she and the other guide at La Casa’s Roswell location are already booked into January.

She said she handles two to four enrollment appointments per day on top of her regular outreach duties at the Roswell clinic. The appointments can take anywhere between 45 minutes and two hours, she said.

Most enrollments through La Casa have been for Medicaid, in part because many of La Casa’s clients are low-income and qualify for the government health plan under its expansion as part of health care reform.

The Roswell clinic enrolled 80 households in Medicaid in October and November, and only one household in an exchange plan in November. Palma-Aarmendariz said she enrolled an additional household in an exchange plan as of Wednesday, bringing the total for the whole La Casa system to two exchange enrollments.

With the exchange website functioning better, Briseno expects the volume of exchange enrollments to increase.

Demand already increased this week, according to Palma-Aarmendariz, who said that she received eight referrals from Eastern New Mexico Medical Center between Monday and Wednesday.

ENMMC conducts enrollment in exchange plans and other health plans such as Medicaid through national corporation Eligibility Screening Services (ESS).

Due to a pending agreement with NMHIX, ESS has been unable to enroll patients in exchange plans. NMHIX spokesperson Debra Hammer said NMHIX accepted the agreement yesterday.

ENMMC has three certified application counselors through ESS, plus two ESS staff and two ENMMC staff undergoing CAC training, according to Debbie Rochford, member services director for the New Mexico Primary Care Association, which oversees various Health Care Guide programs. The counselors differ from guides in that they receive less outreach training.

As La Casa considers expanding its hours and ESS navigates its agreement situation, state entities overseeing the implementation of health care reform in New Mexico are also looking at ways to adapt to the enrollment time crunch.

NMHIX is considering conducting group enrollments, where multiple insurance brokers or guides will sign parties up for health plans simultaneously in a setting such as a computer lab, according to Hammer. She said that in Chaves County, NMHIX may arrange group enrollments at ENMU-Roswell.

“We’re considering anything at this moment, anything that’s going to increase capacity to meet the demand,” said Hammer.

Rochford said another tactic being explored is training more guides and counselors.

But even such an expansion of resources does not mean original enrollment goals will be met. Rochford said that PCA originally projected 1530 Chaves County residents would enroll in exchange plans between Oct. 1 and March 31. The number is based on 2010 Census data and is equal to 28 percent of exchange-eligible Chaves County residents.

Data for the total number of county residents already enrolled is not available according to Rochford. State numbers are paltry, with only 172 New Mexicans enrolling in exchange plans between Oct. 1 and Nov. 2.

With the deadline to sign up for exchange plans that begin Jan. 1 extended from Dec. 15 to Dec. 23, NMHIX is focusing on enrolling parties that would otherwise face gaps in insurance due to their plans expiring at the end of 2013, according to Hammer. She cautioned that those who enroll by the extended deadline should confirm membership details and payment deadlines with their chosen carriers.

Related Posts

Leave a Reply

« »