On a larger scale, state health officials are building a collection of dozens of health indicators that show county-by-county changes in statistics such as obesity rates, infant mortality, life expectancy and access to health care. The effort started in 2011, pulling together various sources of health data that were already available, said Laura Herrera, Maryland's deputy secretary for public health services.

Given only a three-year window before health reform became effective, officials went for the "low-hanging fruit" of readily measurable and available indicators, she said. The aim is to develop more detailed maps of the indicators.

For now, Health Care Access Maryland and other groups are employing the same strategies they have used for years to reach the uninsured.

Health Care Access Maryland, which is responsible for outreach and recruitment for Maryland Health Connections and Medicaid in Baltimore City and Baltimore and Anne Arundel counties under a contract with the state health department, helped lead the state's last major recruitment for expanded Medicaid coverage in 2007.

Executive director Kathleen Westcoat said the group's strategy, based on past lessons, is to hit events where the largest number of people can be reached — events such as the coming African American Heritage Festival in Towson or Latino Fest in Anne Arundel County. The group also sent information home with schoolchildren across the region and is working with churches to get the word out.

But Westcoat acknowledged that if enrollment in new health plans is low after a few months, the group will change gears. She has found over the years that the hardest-to-reach people are found through word of mouth.

"Some people who are vulnerable are not linked to anything, and those are the trickiest people to find," Westcoat said. "Nothing beats that personal interaction. Being where people go is really critical."



For more information

To learn more about Medicaid expansion and the health insurance marketplace:

Call: 1-855-642-8572

Go to: Maryland Health Connection's website at MarylandHealthConnection.gov