May 31, 2023 |  By  Heather Bates, MSW and Herlinda Ibarra

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Our team has a saying – “if people aren’t enrolled in health coverage, health systems change won’t work.” As a firm that’s dedicated to driving health systems change, we know that to stay healthy, people need access to high-quality, affordable, health care. Our mission is to drive systems change to build healthy communities, and enrollment is central to that mission.

Grounded in a health equity perspective, we work with stakeholders to transform health care systems that will see and serve the whole person – and that includes identifying critical systemic linkages to care within communities such as food, housing, education, safety, and economic stability resources.

Our enrollment team brings a deep bench of outreach and enrollment (O&E) strategy, program design, and implementation approaches. With staff experienced in enrolling individuals in Medicaid and Medicare to the Affordable Care Act, we are able to help programs in New York, California, Florida, Delaware, Ohio, and other states. We also have a federally certified navigator on staff, and a key focus of our work is to help outreach and enrollment programs create program efficiencies, streamline their efforts, refresh their vision, and apply strategy and planning activities to help build the skills of their staff.

To hear more about what drives Transform Health’s O&E team, we sat down with our enrollment team, led by Heather Bates, COO & VP of Stakeholder Engagement, along with Sarabeth Zemel, Policy Manager, Herlinda Ibarra,  Assistant Manager of Outreach & Enrollment, Phelan O’Neill, Manager of Operational Excellence, and Elizabeth Wells, Senior Communications Associate. 

Read below to learn about their enrollment programming insights: 

Heather: At twenty-two years old, I started out as a home-visiting social worker for the homebound aging population in New York City. Central to that work was being resourceful and finding any and all benefits and supports that would stabilize my clients in the community. Seeing people get healthy because of an intervention that resulted in addressing a key social determinant of health fueled me to want to move from direct service into policy and national advocacy and make a bigger change—lifting up many voices all together. Enrollment is solutions-oriented and instills a sense of hope. After devoting my career to enrollment into multiple types of benefits and programs, including health coverage from Medicare to the Affordable Care Act, bearing witness to see these new access points open up for all communities has been the most humbling, gratifying, and the greatest gift of a career.

Herlinda: When the ACA expanded coverage, it was very difficult for individuals who had never had access to health insurance to see the full value of the new coverage options. Additionally, the lengthy applications and a long list of new health insurance jargon, made the news of expanded coverage especially difficult to navigate.  When you aren’t in the health care space every day, and you don’t speak the jargon-heavy language, accessing needed health services can feel nearly impossible. Working to break down these complex systems and speak to consumers in plain language has been rewarding throughout my career because I can see how some of the individuals and families I’ve helped are now able to confidently navigate health care. 

Phelan: Policies are only successful when they’re accessible to ordinary people. When I started doing enrollment work in 2014, I saw a special opportunity to educate the public about a once-in-a-lifetime expansion of health coverage. When I organized my first enrollment event, I had the opportunity to help a family get their kids covered for the first time, and from that moment on I understood how special it is to help connect people from coverage to care. I feel especially grateful now to make moments like that easier by using emerging technologies to break down barriers between assisters and consumers.  

Sarabeth: I’ve worked in health policy for many years, and whether a person or family is able to access health services depends on how easy (or hard) it is to enroll in health coverage itself. These policies are constantly changing at both the state and federal levels, so helping our clients understand and interpret these changes is important. Assisters must understand these policy changes in order to successfully enroll those who need health care the most.

Elizabeth: Everyone’s right to make decisions about their own health should be protected, easy to carry out, and not hindered by income level or zipcode. The unfortunate reality is that, in the US, it is challenging to have control over your health without health insurance coverage, and finding the right health insurance coverage for yourself and your family can require very technical expertise. With a background in health care nonprofits and public policy, I’m grateful to continue working with a cross-sector of health care organizations on how to amplify critical linkages to care through engaging and easy-to-understand communications modalities. 

Heather, you’ve spent more than twenty years enrolling people in complex health coverage programs, what would you say are the most important aspects of a successful enrollment program?

Heather: When you have done something for a long time, it is easy to get into patterns that may no longer serve you, or your program, or your partners. I’ve seen how a fresh perspective at everyday practices can help partners and their staff develop a renewed sense of purpose for outreach and enrollment work. Conducting strategic planning style activities can serve as a catalyst to jumpstart creativity again. For example, the strategies we use at Transform Health are inclusive of all staffing levels and can help move the needle with managers, program staff, and partners, when programming feels stifled, or the best outcomes aren’t getting produced. Because of our combined decades of experience, we are able to offer a unique and organizationally tailored approach. This includes layering strategic planning activities with professional development tools, such as work plan development and coaching, while simultaneously providing training, offering technical assistance, and researching enrollment topics. We use this range of tactics to support the year-round work of enrollment, encourage goal development for staff, and create an accountability workflow that will foster workplace culture change, a fresh perspective, and a deeper commitment to outreach and enrollment.

Herlinda, based on your experience working as an enrollment assister in Texas, what would you say are the key skills any enrollment assister must have in order to grow in this work?

Herlinda: Successful enrollment assisters, especially in a state that has not expanded Medicaid, rely heavily on being empathetic, actively listening to individual’s concerns and seeking out solutions to fill gaps in client’s access to healthcare. With ever-changing policies, it is also important for assisters to identify and further develop their expertise. This may include engaging partners to participate in training workshops around specific communities (LGBTQ+, migrant workers, people experiencing homelessness, etc.), seeking out other opportunities for professional development, and always involving a level of individual goal setting and work planning.

Looking ahead, how can organizations ensure their outreach and enrollment programs are sustainable, especially during times of federal administration changes? What will we want to look for?

Heather: We know people will continue to need access to health care, and affordable coverage, regardless of the political climate. Therefore, it’s essential that organizations understand how to accomplish their goals using different funding streams over time and know how to articulate the importance of the work they do. Enrollment programs need to learn to be ten steps ahead of any potential funding changes and be prepared to amplify the outcomes of their work l in any setting, at any time. This requires a clear understanding of the language of enrollment to be able to translate it accurately to any audience, but it also requires a level of programmatic rigor to instill confidence when political or financial threats present themselves.

Examples of how to plan for the ebb-and-flow of funding requires strategic planning, include:

Transform Health Outreach & Enrollment Services

  • Create and maintain ongoing relationships with partners when you can’t be the lead and need to subcontract your work;
  • Maintain a drumbeat: repeat key messages and uplift your organization’s services so that funders and others are continually reminded about your work;
  • Identify different but parallel types of funding streams in the public and private sectors that allow you to retain your trained staff as public opinion shifts;
  • Build strong and lasting partnerships within and across public and private sectors, especially within the community you serve;
  • Ensure consistent follow-through with partners—do what you promise and close the loop;
  • And, document your work through work planning and workflows—make it clear how you move communities and help them navigate social determinants of health.

Applying these examples will help build the legacy of your program, and make it indispensable to your community. Forecasting for leaner times, maintaining deep community partnerships, and consistently uplifting the outcomes of your work to a variety of audiences year-round will be critical for navigating, and potentially weathering, change.

Work with Us

You heard it first-hand from our team. If you want to learn more about the types of outreach and enrollment work we do reach out to us. We would love to hear from you! We always work to meet an organization/client where they are on cost, including possible discounted rates for nonprofit groups.  

Contact Heather at to discuss a partnership with Transform Health.