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Field
Abstract
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Before
Each year, millions of Medicaid beneficiaries must redemonstrate their eligibility to avoid losing coverage. Challenges with the required paperwork can result in eligible people losing their benefits for procedural reasons (i.e., because their paperwork was missing or contained errors). In 2023 alone, 9 million people lost Medicaid coverage for procedural reasons. This study will evaluate an intervention aimed at averting and remediating loss of Medicaid coverage for procedural reasons among eligible individuals. The experimental population includes 425,000 households in Wisconsin who lost Medicaid coverage for procedural reasons. The implementation partner is Covering Wisconsin, Wisconsin’s federally certified Navigator organization. Experimental arms include a group receiving a pre-recorded outbound call, a group receiving a live outbound call from a Navigator, and a no-outreach control group. We hypothesize that outreach from a Navigator will increase Medicaid re-enrollment, and although a pre-recorded call will be the most cost-effective option, a live call will be more effective among underserved or harder-to-reach populations. The goal of this research is to identify novel outreach methods to help low-income people maintain access to benefits, and thereby facilitate the advancement of equity in access to the safety net.
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After
Each year, millions of Medicaid beneficiaries must redemonstrate their eligibility to avoid losing coverage. Challenges with the required paperwork can result in eligible people losing their benefits for procedural reasons (i.e., because their paperwork was missing or contained errors). In 2023 alone, 9 million people lost Medicaid coverage for procedural reasons. This study will evaluate an intervention aimed at averting and remediating loss of Medicaid coverage for procedural reasons among eligible individuals. The experimental population includes 130,000 households in Wisconsin who lost Medicaid coverage for procedural reasons. The implementation partner is Covering Wisconsin, Wisconsin’s federally certified Navigator organization. Experimental arms include a group receiving a pre-recorded outbound call, a group receiving a live outbound call from a Navigator, and a no-outreach control group. We hypothesize that outreach from a Navigator will increase Medicaid re-enrollment, and although a pre-recorded call will be the most cost-effective option, a live call will be more effective among underserved or harder-to-reach populations. The goal of this research is to identify novel outreach methods to help low-income people maintain access to benefits, and thereby facilitate the advancement of equity in access to the safety net.
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Field
Trial Start Date
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Before
July 01, 2024
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After
September 01, 2024
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Trial End Date
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Before
December 31, 2025
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After
February 28, 2026
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Last Published
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Before
July 08, 2024 02:57 PM
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After
July 17, 2024 05:38 PM
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Intervention Start Date
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Before
July 01, 2024
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After
September 01, 2024
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Intervention End Date
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Before
December 31, 2025
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After
February 28, 2026
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Field
Experimental Design (Public)
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Before
The experimental population will include people in Wisconsin who lost Medicaid coverage for procedural reasons at any time between June 2024 and November 2025. Exclusion criteria include preferring a language other than English, Spanish, or Hmong, and lacking a working phone number.
Assignment to treatment arms will occur monthly from July 2024 to December 2025. Randomization will be clustered by household. Households will be assigned to treatment arms in equal numbers, stratified by key characteristics that can affect eligibility and enrollment processes.
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After
The experimental population will include people in Wisconsin who lost Medicaid coverage for procedural reasons at any time between August 2024 and January 2026. Exclusion criteria include preferring a language other than English, Spanish, or Hmong, and lacking a working phone number.
Assignment to treatment arms will occur monthly from September 2024 to February 2026. Randomization will be clustered by household. Households will be assigned to treatment arms in equal numbers, stratified by key characteristics that can affect eligibility and enrollment processes.
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Field
Planned Number of Clusters
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Before
Based on an analysis of microdata from Wisconsin and state-level and national data from KFF, we estimate at least at least 509,000 people, or about 425,000 households, will meet the inclusion criteria.
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After
Based on an analysis of microdata from Wisconsin and state-level and national data from KFF, we estimate around 130,000 households will meet all the inclusion criteria.
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Planned Number of Observations
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Before
509,000 people
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After
156,000 people
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Field
Sample size (or number of clusters) by treatment arms
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Before
Live outbound call from a Navigator 13,500 households
Pre-recorded outbound call 100,000 households
No-outreach control arm At least 311,000 households
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After
Live outbound call from a Navigator 13,500 households
Pre-recorded outbound call (45% of the sample) ~58,000 households
No-outreach control arm ~58,000 households
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Field
Power calculation: Minimum Detectable Effect Size for Main Outcomes
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Before
Based on this sample size and the projected division of households across treatment arms, the study will have 80% power to detect impacts of the live call on Medicaid coverage within 6 months as small as 1.2 percentage points, impacts of the pre-recorded call as small as 0.5 percentage points, and differences between the live and pre-recorded calls as small as 1.3 percentage points.
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After
Based on this sample size and the projected division of households across treatment arms, the study will have 80% power to detect impacts of the live call on Medicaid coverage within 6 months as small as 1.3 percentage points, impacts of the pre-recorded call as small as 0.8 percentage points, and differences between the live and pre-recorded calls as small as 1.3 percentage points.
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Field
Pi as first author
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Before
No
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After
Yes
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