• Omar Viramontes, Michael Hochman, Martin Lee Serota, Elvia Delgado, and Gerardo Moreno.
• UCLA Health and Department of Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA, 90024, USA. oviramontes@mednet.ucla.edu.
• Bmc Health Serv Res. 2018 Sep 21; 18 (1): 729.

BackgroundThe Affordable Care Act (ACA) has improved healthcare access in the community health centers that have played a critical role in enrolling low income and minority patients. This study examined the ACA enrollment for one of the largest federally qualified community health centers in the country.MethodsAn exploratory sequential mixed method study was used as the main qualitative and quantitative approach for this study. Key stakeholders (n = 6) were interviewed as part of the qualitative component, and information about barriers and best practices were acquired. As part of the quantitative analysis, we examined cross-sectional data among 59,272 AltaMed enrollees in 2013-2015. We analyzed data on age, gender, language, ethnicity, and enrollment periods. The interviews were conducted first and followed by the data analysis.ResultsAltaMed was the top enroller of patients in ACA insurance plans in California (2013-14 and 2014-15) through the state exchange and Medicaid expansion. Using key stakeholder interviews, 5 main barriers were identified and 5 innovative solutions that allowed AltaMed to enroll people into the state exchange and Medicaid expansion. Barriers to enrollment included training, new workflows, and enrollment of Young Invincibles, and these enrollment barriers were overcome with community health workers.ConclusionEnrollment barriers were overcome through AltaMed's community-based approach and long term community partnerships.

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