Interventions to Increase Affordable Care Act Marketplace Enrollment: A Systematic Review and Meta-Analysis.

Over 10 million uninsured individuals are eligible for subsidized health insurance coverage through the Affordable Care Act (ACA) marketplaces, and millions more were projected to become eligible with the end of the federal COVID-19 Public Health Emergency in 2023. Individual studies on behaviorally...

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Publicado en:Population Health Management Vol. 27; no. 5; pp. 327 - 338
Autores principales: Martin, Lizzie, Feher, Andrew, Schultz, William, Safran, Elana, Cohen, Alison K.
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2024
      vid: 27
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.1089/pop.2024.0091
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        atl: Interventions to Increase Affordable Care Act Marketplace Enrollment: A Systematic Review and Meta-Analysis.
      aug:
        au:
          Martin, Lizzie
          Feher, Andrew
          Schultz, William
          Safran, Elana
          Cohen, Alison K.
        affil: Office of Evaluation Sciences, U.S. General Services Administration, Washington, District of Columbia, USA.
      sug:
        subj:
          Health Insurance Exchanges
          Government Programs
          Information Resources
          Program Evaluation
          Human
          Systematic Review
          Meta Analysis
          Descriptive Statistics
          PubMed
          CINAHL Database
          Confidence Intervals
          Effect Size
          Policy Making
          Patient Protection and Affordable Care Act
          Checklists
          Health Care Costs
          Learning
          Support, Psychosocial
          Medically Uninsured
          COVID-19 Pandemic
      ab: Over 10 million uninsured individuals are eligible for subsidized health insurance coverage through the Affordable Care Act (ACA) marketplaces, and millions more were projected to become eligible with the end of the federal COVID-19 Public Health Emergency in 2023. Individual studies on behaviorally informed interventions designed to encourage enrollment suggest that some are more effective than others. This study summarizes evidence on the efficacy of these interventions and suggests which administrative burdens might be most relevant for potential enrollees. Published and unpublished studies were identified through a systematic review of studies assessing the impact of behaviorally informed interventions on ACA marketplace enrollment from 2014 to 2022. Thirty-four studies comprising over 18 million participants were included (32 randomized controlled trials and 2 quasiexperimental studies). At the time of data extraction, 8 were published. Twenty-seven of the studies qualified for inclusion in a meta-analysis, which found that the average rate of enrollment was about 1 percentage point higher for those who received an intervention (0.009, P < 0.001), a 24% increase relative to control households; for every 1000 people who receive an intervention, that would correspond to about 9 additional enrollees. When stratifying by intervention intensity, support-based interventions increased enrollment by 2 percentage points (0.020, P = 0.004), while information-based interventions increased enrollment by 0.6 percentage points (0.006, P < 0.001). The meta-analysis found that behaviorally informed interventions can increase ACA marketplace enrollment. Interventions aimed at alleviating compliance costs by providing enrollment support were about three times as effective as information alone.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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