2019 Intake Marketing Survey Overcoming Barriers to Growth: 2019 Intake/Marketing Survey Question Title * 1. About You Name Organization H Number Email OK Question Title * 2. Currently, what is your biggest barrier to growth? OK Question Title * 3. Please rate each barrier to growth on a scale from 1 to 10, with 10 being a big barrier to growth. Lack of Community Awareness Medicaid Eligibility Determination Keeping Community Doctor Competition Lack of Referrals Rate of Disenrollment PACE Center Capacity Census Cap Other OK Question Title * 4. If you chose "Other" in the above question, please describe. OK Question Title * 5. Please rate the importance of each referral source on a scale from 1 to 10, with 10 being the most important referral source. Area Doctors Sponsoring Organization Area Agency on Aging Van Signage Paid Advertising Social Media Website Participants Staff Senior Housing Media Coverage State Health Insurance Program Enrollment Brokers Other OK Question Title * 6. If you selected "Other" above, please describe. OK Question Title * 7. What is the typical number of days it takes your state to determine Medicaid eligibility? 1-3 4-7 8-14 15-30 31-60 > 60 OK Question Title * 8. What software, if any, do you use to track the intake process? OK Question Title * 9. Other than total enrollments, what key performance measure do you do to evaluate intake performance? OK Question Title * 10. For a person otherwise qualified to enroll, what is the most common reason they give for not enrolling? OK Question Title * 11. In the intake/marketing process, what outside resources have you used in the last three years? Advertising Agency Graphic Designer Events Planner Fundraiser Sales Trainer Public Relations Spokesperson Web Developer Social Media Expert Medicaid Eligibility Expert Other (please specify) OK Question Title * 12. If you could employ outside consultants for intake/marketing, who would you hire? Please rank those listed. Choose N/A for any you would not hire. Advertising Agency Graphic Designer Events Planner Fundraiser OK Question Title * 13. Any"Other" outside consultants? OK Question Title * 14. What positions does your marketing/intake department have? Marketing/Enrollment Manager Marketing Manager Enrollment Manager Marketing/Sales Specialist Enrollment Specialist Review Nurse Medicaid Specialist Administrative Assistant/Phones Other (Please Specify) OK Question Title * 15. For PACE participants who voluntary disenroll (not due to death), what are the most common reasons? OK Question Title * 16. Besides English, what languages do you make your printed marketing materials available in? Spanish Mandarin Cantonese Tagalog Vietnamese Arabic French Korean Russian German Haitian Creole Hindi Portuguese Italian Polish Urdu Other (please specify) OK Question Title * 17. Do you have a policy that allows a participant to visit a community physician after enrollment? Yes No OK Question Title * 18. How many FTEs work in Intake or Marketing for your PACE organization? OK Question Title * 19. Does the full IDT determine eligibility to enroll in PACE? Yes No, it is determined by a smaller assessment team. Other (Please Specify) OK Question Title * 20. If your full IDT does not determine enrollment, what members of the IDT are involved? Physician Nurse Social Worker Intake OT PT Dietitian Transportation Home Care Other (please specify) OK Question Title * 21. What National PACE Month Resources did you utilize in September 2018? Activities Guide Sample Press Release National PACE Month Poster Guide for Hosting Elected Leaders Promotional items National PACE Month Proclamation PACE Infographics Other (please specify) OK Question Title * 22. What can NPA do more of to help you grow enrollment? OK DONE