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U.S. Department of Health and Human Services

Office of Minority Health

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Benefits Data Trust (BDT)

Philadelphia, PA, 19103

Project: Insuring Shared Prosperity: A Comprehensive Model of Education, Outreach and Application Assistance

Amount: $247,268

Project Abstract
Philadelphia has the highest poverty rate of the nation’s ten largest cities. Significant racial and ethnic health disparities related to the social determinants of health persist, such as increased rates of unemployment, reduced access to healthy food, lack of insurance, and lower than average rates of high school graduation and social capital.  One of the largest barriers preventing racial and ethnic minorities from enrollment in affordable health insurance is Pennsylvania’s decision not to expand Medicaid, with the majority of low-income African Americans and Latinos currently falling into the coverage gap.

The purpose of the project is to achieve equity in access to health insurance by increasing enrollment rates among racial and ethnic minorities through the program Insuring Shared Prosperity (ISP).  ISP represents a comprehensive, multi-agency, and multi-channel communication strategy to connect low-income minority communities to health coverage. ISP builds upon a citywide anti-poverty plan, known as Shared Prosperity, which was developed by the Philadelphia Mayor’s Office of Community Empowerment and Opportunity. One of the first investments in the Shared Prosperity agenda was the establishment of comprehensive benefits application and enrollment centers, known as BenePhilly Centers, within existing community-based organizations (CBOs) in low-income neighborhoods throughout Philadelphia. ISP will expand on this effort by incorporating Affordable Care Act (ACA) outreach and enrollment activities into the broader plan to address access barriers, as well as health and economic disparities, facing Philadelphia’s most vulnerable residents–most of whom are racial or ethnic minorities and many of whom face significant language barriers.

ISP proposes a two-tiered communication and outreach strategy to overcome reaching hard-to-reach people. First, ISP will employ a data-matching strategy that relies on benefit enrollment lists to identify 10,000-15,000 low-income, minority households who are likely to be uninsured. ISP will then conduct targeted outreach via mail (and in some cases, telephone and text messaging) to let likely eligible consumers know about the ACA and that free enrollment assistance is available. Second, ISP will leverage traditional community outreach strategies, including education sessions, leadership trainings, and other promotional activities at CBOs. BenePhilly Centers will educate and screen for health insurance for 5,000 individuals. ISP will seek to leverage the effectiveness and efficiency of all the ACA-related outreach and enrollment activity in Philadelphia by improving coordination among benefits counselors and other social service providers. BDT will also provide training and oversight of outreach and enrollment activities at BenePhilly Centers along with overall coordination and management of the project. BDT will provide Benefits Outreach Specialists who speak a variety of languages, including Spanish, Cantonese, Creole, Hindu, Urdu, Punjabi, and Russian. ISP through BDT will provide language assistance support and translation services.

The expected outcomes of this work include a reduction in the uninsured rate among minorities in Philadelphia; an increase in consumers who have learned about the availability of affordable health coverage; an increase in consumers who have learned about health coverage options and who have received comprehensive application and enrollment support; and the ability for newly enrolled minority households to better access health care services and have increased financial security. The long-term impacts that ISP hopes to achieve are: (1) equity in terms of access to health insurance; and (2) improved health outcomes due to increased access to quality, affordable health care.

Numerous process measures will be collected to monitor the program and determine the success of the various outreach strategies. The project will test strategies on a small scale, evaluate their success in real-time, and adapt as necessary. Outreach messages will be tested with focus groups to assess trustworthiness of the messenger, the salience to the needs and concerns of the target population, and the cultural acceptability of the materials. Communication methods will be evaluated with an experimental design. Since outreach will be conducted in successive waves, each wave will serve as a randomized experiment. Evaluators will measure the effectiveness of each strategy within each wave of outreach in the form of a response rate and look for differences by geography (zip code) and race/ethnicity. Another major component of the program is the partnership with the BenePhilly Centers and other CBOs. Part of the ISP program includes training, technical assistance, and language support for the partners. The capacity of CBOs to provide in-person assistance and education following receiving in-person training or assistance from BDT will be evaluated with a pre-and-post survey. The survey will measure the partners’ knowledge and attitudes toward the ACA, their comfort providing assistance and education, and perceived facilitators and barriers to enrolling individuals.

Performance measures include:
Outreach and education:

    • Total number of consumers served by outreach and education efforts;
    • Number and type of sources used for targeted outreach;
    • Number and percentage of households receiving and responding to targeted outreach, by zip code;
    • Response rates to various communication strategies by race/ethnicity and zip code;
    • Number and type of language support and translation services provided;
    • Number of CBOs trained;
    • Number of new volunteer, community-based trainers conducting ACA presentations in their communities; and
    • Number of individuals, including minorities, referred to BenePhilly Centers for comprehensive benefits assistance, including health coverage.


    • Number and percentage of responders applying for any benefit, by zip code and race/ethnicity;
    • Number and percentage of responders applying for health insurance, by zip code and race/ethnicity;
    • number of consumers screened for eligibility;
    • Number of consumers who apply for any benefit;
    • Number and percentage of consumers applying for health insurance;
    • Number and percentage of consumers successfully enrolling in coverage; and
    • Number of consumers provided with follow-up support and troubleshooting to overcome enrollment barriers.

Community Capacity:

    • Number and type of community and faith-based leaders engaged;
    • Number of benefits counselors trained and approved as Certified Application Counselors (CACs), including number of multi-lingual counselors;
    • Number of education and leadership trainings completed;
    • Number of new ACA coalition meetings;
    • Number of benefits counselors/navigators/CACs attending monthly coalition meetings; and
    • Number in attendance from BenePhilly Centers at monthly supervisor meetings. 

Leadership: Strengthen and broaden leadership for addressing health disparities at all levels.
Health System and Life Experience: Improve health and healthcare outcomes for racial, ethnic, and underserved populations.
Cultural and Linguistic Competency: Improve cultural and linguistic competency and the diversity of the health-related workforce.


  • AHS-1: Increase the proportion of persons with health insurance.
11/12/2015 6:35:00 PM