By Sarah Sonies
New Mexico has one of the nation’s highest rates of uninsured. With the expansion of Medicaid and New Mexico’s participation in the federal health insurance exchange, over 300,000 New Mexicans are eligible to enroll in a health insurance plan. Medical residents at the University of New Mexico (UNM), working with the UNM Business School and the New Mexico Center for Law and Poverty, have developed a mobile app to disseminate information on enrolling in health insurance and Medicaid to people who are newly eligible for coverage.
The Get Covered New Mexico app is designed to provide patients with clear information on how and where to obtain coverage, in addition to serving as a tool for community health workers and enrollment navigators throughout the state. Kate McCalmont, MD, is a second-year family medicine resident at UNM who is leading the effort.
“As information [about Medicaid expansion in New Mexico] began appearing in the news and with ads on billboards encouraging people to enroll in the exchanges, I started brainstorming how to get the word out to many people simultaneously,” she says.
“Our initial hope was to develop an app to physically enroll people, but because New Mexico is using the federal exchange, there were challenges to doing that. We then thought about developing an app that directs people to registration links and gives people information they need to register. I connected with other residents and a professor at University of New Mexico’s Business School and we sat down and began to draft ideas.”
McCalmont’s idea was a grassroots effort, born of spare time and in spite of lack of funds. She and her colleagues had a lot of interest from leadership at UNM. The UNM Hospital is located in Bernalillo County and serves as a safety net hospital for an underserved population, many of whom are part of the UNM Care Program. UNM Care is subsidized health care plan for patients who use the UNM system, but is not really health insurance.
The bootstrap operation generated cooperation and collaboration. “We were able to work with people who do very different things across the organization on something that could really impact our community,” she says. “We worked with lawyers at the New Mexico Center for Law and Poverty who provided ongoing feedback and served as advisors. We also worked with people from the business school who did a lot of the design for the pages and text. Then, we had experts on health literacy review the text to make sure that the reading level was appropriate for consumers.”
The app has an eligibility calculator and directs consumers to places they can go and websites they can visit to enroll. It not only directs people to the right place, but prepares them with the right information. Clinics in Albuquerque and across New Mexico have enrollment navigators who can help people sign up for the exchanges.
“Hopefully, the app will direct people to take on that individualized support should they need it. At UNM, we are connecting patients to the financial services office to choose the appropriate options so they can get services that are subsidized as much as possible,” says McCalmont.
She reports that the project team has had some difficulty studying engagement. The app was approved for use by the Apple store in mid-November but word was slow to spread initially. However, once the local TV and NPR stations covered the app release, downloads jumped.
“In the future, we are hoping to develop a way to track people who have downloaded the app with their actual outcome – i.e. did they enroll, did they become insured?” McCalmont says. “We can easily track downloads, that is a very simple metric, but I think we all recognize that is not what we are looking for. We are looking for increased enrollment in New Mexico’s health insurance exchanges. One idea we have for the future to better track this metric is reaching out to those who have downloaded the app two weeks after the download with some sort of follow-up question: Did you enroll, and if so, in what plan?”
Although a little early for measurable results, McCalmont and her team have gotten good feedback from users. They hope to facilitate its spread by encouraging people in every clinic and hospital to reach out to patients and community members.