The Take-Up Study: Optimizing Enrollment Strategies for Medicaid Expansion


Major Research Questions
Which outreach processes are most successful in increasing enrollment among Medicaid-eligible populations?

What is the impact of enrollment in Medicaid on health care use and outcomes for vulnerable and hard-to-reach populations?
  • Katherine Baicker, Ph.D., Harvard School of Public Health
  • Cathleen H. Kaufmann, MSW, Portland State University for OHA
  • Ginny Garcia-Alexander, Ph.D., Portland State University
Project Timeline
Jan. 2013 - Jan. 2016
When can we expect to see results?

Additional Information

Why study take-up?
The 2014 Affordable Care Act Medicaid Expansion expands eligibility for public health insurance.  However, research has shown that many people who are eligible for public benefits don’t take them up.   

The success of the expansion depends upon high levels of enrollment. Insurance premiums are based on risk; the more people you have in the risk pool, the lower the risk overall.  If the only people who sign up for Medicaid under the expansion are the ones who are sick and in immediate need, then the risk pool will be imbalanced.  

Furthermore, coverage for “sick care” isn’t the only function of public assistance; Medicaid is also supposed to provide preventive care services to keep people from getting sick down the road. If we can increase enrollment among healthy people, can we have an impact on health outcomes in the future?

Study design
Participants in the Takeup Study are Oregonians who, because of their income levels, are likely to become eligible for Medicaid under the 2014 expansion. 

Participants are randomized into three groups. One group receives Oregon’s standard outreach procedure. The second receives the standard procedure plus some low-cost enhanced outreach efforts. The third group receives more intensive outreach and enrollment assistance.

We’ll measure enrollment and utilization outcomes for participants in all three groups to see whether enhanced outreach efforts are effective and whether they lead to improved health outcomes for those who would have been hard to recruit into public assistance.

What if I’m a participant in the study?
We’d love to hear from you. You can give us a call at 1-877-215-0686.
If you know you were selected in a previous Oregon Health Plan Standard Reservation lottery list, but missed the deadline, call the Oregon Health Plan Processing Center at 1-800-699-9075.

For more information about this project, you can contact CORE.