Mathematica Policy Research, Ann Arbor, MI.
Health Serv Res. 2018 Feb;53(1):341-365. doi: 10.1111/1475-6773.12630. Epub 2016 Dec 12.
To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period.
DATA SOURCES/STUDY SETTING: Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activities and baseline local-area demographic, economic, and health services characteristics.
We used a quasi-experimental design, comparing Marketplace enrollment during the first open enrollment period in local areas drawn from Enroll America field states to a comparison group of local areas drawn from states that were not served by Enroll America's field effort, but that otherwise match up well with Enroll America states.
We find evidence of a large, positive effect of Enroll America's field outreach on Marketplace enrollment in non-Medicaid expansion states. Across model specifications, the Enroll America effects on Marketplace enrollment ranged between 10 and 15 percent, with most estimates statistically significant at the 5 percent level.
Enroll America played an important role in the success of individual states' efforts to boost Marketplace enrollment. Enroll American's evidence-driven, grassroots approach could serve as a model for others interested in conducting similar outreach campaigns for Affordable Care Act-related coverage.
评估“美国报名”（Enroll America）的外展活动对市场覆盖范围内参保人数的影响，考察其对初始开放参保期内参保人数的影响。
资料来源/研究范围：将初始开放参保期内的市场覆盖参保人数与“美国报名”的外展活动数据及基线地区人口统计学、经济和卫生服务特征相关联。
采用准实验设计，将“美国报名”外展活动涉及的州的参保人数与未开展“美国报名”外展活动、但在其他方面与“美国报名”各州匹配良好的州的参保人数进行比较，以此考察初始开放参保期内参保人数。
我们发现“美国报名”外展活动对非医疗补助扩张州的市场参保人数有显著的积极影响。在各种模型中，“美国报名”对市场参保人数的影响在 10%至 15%之间，其中大多数估计在 5%的水平上具有统计学意义。
“美国报名”在各州扩大市场参保人数方面发挥了重要作用。“美国报名”的循证、基层方法可以为其他有兴趣开展与平价医疗法案相关的类似外展活动的机构提供借鉴。
