Objectives: Assess the outreach and enrollment strategies implemented by Florida Community Health Centers, Inc. (FCHC) to enroll eligible but not insured community members in Medicaid and other benefits programs.

Methods: Researchers conducted semi-structured interviews with 24 staff members and patients, conducted ethnographic observations, administered a short staff survey, and collected outreach related print materials for analysis. FCHC, Inc. provided enrollment numbers to compliment qualitative interview data about the program’s impact. Data were analyzed using Atlas.ti.

Results: Results suggest that FCHC’s outreach and enrollment model increases healthcare access for eligible, low-income and hard-to-reach patients in their service area who face barriers to enrollment. 87% of patient participants reported facing more than one barrier to enrollment and 100% of the Spanish speaking participants reported concurrently facing three or more barriers to enrollment. 80% of patient participants reported that they had, at one time, tried and failed to apply for Medicaid or other benefits as a result of encountering least one of these barriers. By using tailored, culturally appropriate in-reach and outreach strategies, providing application assistance, and employing culturally competent outreach coordinators, FCHC has reduced their uninsured rate to 16.2% (8% lower than Florida and 2% lower than the U.S.). In addition, 97% of the patients who worked with FCHC were approved for benefits and 100% of patients interviewed regularly used benefits.

Conclusion: We suggest that these promising practices could be replicated in other similar contexts by CHCs with “hard-to-reach” populations who are more likely to be uninsured.