Health BehaviorNCT05216458
Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality
A study testing Emails and letter intervention in people with Health Behavior, run by Office of Evaluation Sciences at 1 site in United States.
Trial summary
With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $0 -- or $1 per member per month (PMPM) in Marketplaces that include abortion coverage -- health insurance coverage across the ACA Marketplaces. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Health Behavior
- What is being tested?
- Emails and letter intervention
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44,000 participants
- Where
- 1 siteUnited States
- Study dates
- 27 May 2021to 31 Aug 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Submitted a Covered California application for the 2021 coverage year and found eligible for a $1 PMPM Enhanced Silver 94 plan
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality in California's ACA Marketplace
With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $0 -- or $1 per member per month (PMPM) in Marketplaces that include abortion coverage -- health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine whether personalized letters and email reminders can increase health insurance enrollment, CSR Silver take-up and $1 PMPM coverage.
- Conditions
- Health Behavior
- Being tested
- Emails and letter intervention, Control group
- Keywords
- Affordable Care Act, randomized controlled trial, nudge, American Rescue Plan
- Medical subject headings
- Health Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Emails and letter interventionBehavioural
Emails and letters for households assigned to the treatment group
Control groupBehavioural
No outreach during the intervention period.
| Study group | Role | What they receive |
|---|---|---|
| Control | Experimental | Households in the control group did not receive any messages during the intervention period from June 2021 to August 2021 Receives: Behavioral: Control group |
| Generic Outreach | Experimental | Households in the generic outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees, which explain that nearly all Covered California members get subsidies to pay for health insurance and encourage them to explore their plan options using an online Shop \& Compare tool.
For the generic arm, the outreach materials described new financial assistance under the American Rescue Plan and noted the availability of plans as low as $1/month. Receives: Behavioral: Emails and letter intervention |
| Personalized Outreach | Experimental | Households in the personalized outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees.
For the personalized arm, the outreach explicitly informed the household that they were eligible for a $1/month CSR Silver 94 plan and described the benefits this plan confers. The outreach materials for the personalized group were not only designed to increase enrollment, but also to simplify the search process by providing households with a clear recommendation to pick a CSR Silver plan; this included highlighting the low out-of-pocket costs these plans provide when accessing care, a screenshot of what the plan would look like when they entered the shopping portal and peer comparison language that noted 9 out of 10 consumers like them choose CSR Silver plans Receives: Behavioral: Emails and letter intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percent of households enrolled in an ACA plan
Percent of households enrolled in an ACA plan based on Covered California administrative data
Measured: Three months
Percent of households who chose a CSR Silver plan
Percent of households in a CSR Silver plan based on Covered California administrative data
Measured: Three months
Percent of households who enrolled in a $1/month net-of-subsidy premium plan
Percent of households who enrolled in a $1/month net-of-subsidy premium plan based on Covered California administrative data
Measured: Three months
Secondary outcomes (1)
Percent of households who logged into their online account
Percent of households who logged into their online account based on Covered California administrative data
Measured: Three months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Jan 2022
- Study start27 May 2021
- Primary completion31 Aug 2021
- Study completion31 Aug 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Health BehaviorStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 44,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- Office of Evaluation Sciences
- Sponsor type
- US federal agency
- Responsible party
- Principal investigator, Andrew Feher, Office of Evaluation Sciences
- Investigators
- Andrew Feher, PhD, Study director, Covered California
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05216458
- Sponsor's protocol ID
- 05272021
- Status last verified
- Jan 2022
- First submitted
- 31 Dec 2021
- Last updated
- 31 Jan 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The researchers are committed to sharing as much data as possible for replication, consistent with the privacy and security requirements of the state agency that govern the re-disclosure of the data.
Study at a glance
From the registry record, last updated by the sponsor on 31 Jan 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality in California's ACA Marketplace
- ClinicalTrials.gov ID
- NCT05216458
- Acronym / sponsor ID
- 05272021
- Conditions
- Health Behavior
- Keywords
- Affordable Care Act, randomized controlled trial, nudge, American Rescue Plan
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 44,000 participants (actual)
- Lead sponsor
- Office of Evaluation SciencesUS federal agency
- Study start
- 27 May 2021 (actual)
- Primary completion
- 31 Aug 2021 (actual)
- Study completion
- 31 Aug 2021 (actual)
- First posted
- 31 Jan 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $0 -- or $1 per member per month (PMPM) in Marketplaces that include abortion coverage -- health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine whether personalized letters and email reminders can increase health insurance enrollment, CSR Silver take-up and $1 PMPM coverage.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Control | Experimental | Behavioral: Control groupHouseholds in the control group did not receive any messages during the intervention period from June 2021 to August 2021 |
| Generic Outreach | Experimental | Behavioral: Emails and letter interventionHouseholds in the generic outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees, which explain that nearly all Covered California members get subsidies to pay for health insurance and encourage them to explore their plan options using an online Shop \& Compare tool. For the generic arm, the outreach materials described new financial assistance under the American Rescue Plan and noted the availability of plans as low as $1/month. |
| Personalized Outreach | Experimental | Behavioral: Emails and letter interventionHouseholds in the personalized outreach group were assigned to receive a letter and two email reminders in June 2021 and thereafter received the standard messages Covered California sends to prospective enrollees. For the personalized arm, the outreach explicitly informed the household that they were eligible for a $1/month CSR Silver 94 plan and described the benefits this plan confers. The outreach materials for the personalized group were not only designed to increase enrollment, but also to simplify the search process by providing households with a clear recommendation to pick a CSR Silver plan; this included highlighting the low out-of-pocket costs these plans provide when accessing care, a screenshot of what the plan would look like when they entered the shopping portal and peer comparison language that noted 9 out of 10 consumers like them choose CSR Silver plans |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Submitted a Covered California application for the 2021 coverage year and found eligible for a $1 PMPM Enhanced Silver 94 plan
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Emails and letter interventionEmails and letters for households assigned to the treatment group | Behavioural | Generic Outreach, Personalized Outreach |
| Control groupNo outreach during the intervention period. | Behavioural | Control |
Primary outcome
Percent of households enrolled in an ACA plan
Time frame: Three months
Percent of households enrolled in an ACA plan based on Covered California administrative data
Percent of households who chose a CSR Silver plan
Time frame: Three months
Percent of households in a CSR Silver plan based on Covered California administrative data
Percent of households who enrolled in a $1/month net-of-subsidy premium plan
Time frame: Three months
Percent of households who enrolled in a $1/month net-of-subsidy premium plan based on Covered California administrative data
1 secondary outcome
Percent of households who logged into their online account
Time frame: Three months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Jan 2022.
- Individual participant dataSharing planned: Yes. The researchers are committed to sharing as much data as possible for replication, consistent with the privacy and security requirements of the state agency that govern the re-disclosure of the data.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Andrew Feher, PhD study director
Covered California
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Emails and letter intervention in people with Health Behavior, run by Office of Evaluation Sciences at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percent of households enrolled in an ACA plan (time frame: Three months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jan 2022.