Evaluation of the Consumer Voices for Coverage Initiative, Phase 3

Evaluation of the Consumer Voices for Coverage Initiative, Phase 3

Published: Dec 30, 2015
Publisher: Princeton, NJ: Robert Wood Johnson Foundation

Mary Harrington

Key Findings

Key Findings:

  • The theory of change for the CVC program is at core about ensuring that consumer experiences inform and benefit from state program and policy decisions. The supporting framework for consumer advocacy is a coalition or network of organizations led by CVC grantees that work together to plan, coordinate, assess, and support efforts to find and engage consumers; help them get connected with coverage; and establish feedback loops between consumers and program and policy officials.
  • Consumer issues grantees focused on included network adequacy, network transparency, surprise billings and out-of-network coverage issues, essential community providers, and insurers dropping out or merging. Procedural issues addressed included the processes for Marketplace determinations, appeals, and transitions between Medicaid and the Marketplaces.
  • While a few grantees had secured funding for specific activities or some level of coalition work after CVC funding ends, many struggled to secure enough support for continuing the full range of activities. Grantees see potential for new funding sources for consumer health advocacy work focused on “next generation” access issues involving delivery system and payment reforms, provider networks, health literacy issues and the like.
  • Grantees could use additional help in making the case that consumer health advocacy work is valuable to potential funders, including showing how their coalitions, policy analysis skills, media connections, and advocacy feedback loops can help achieve the outcomes funders care about.

The evaluation focused on the activities and outcomes reported by 18 grantees in the final phase of the Robert Wood Johnson Foundation initiative, Consumer Voices for Coverage (CVC). The CVC work focused on building capacity in underserved communities to engage local leaders and consumers to put systems in place that would help consumers obtain and keep coverage and establish feedback loops so that consumer experiences could inform program and policy decisions. The work involved documenting and assessing: CVC’s theory of change; the functioning of CVC coalitions and networks; activities to engage and support consumers; how feedback loops worked to tap consumer experiences in seeking and obtaining coverage to identify problems and bring them to the attention of state officials; the results and outcomes of these efforts; what worked well and what could have been improved; and aspects of the CVC approach that are more sustainable and why. The evaluation was funded by the Robert Wood Johnson Foundation.

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