Master's Project Title:

Is Text Messaging a Feasible and Appropriate Outreach Strategy to Increase Postpartum Visit Rates Among Medicaid Recipients?

MCH Student:

Jennifer Hauser

Date of Defense:

July 19, 2013


Background: Medicaid recipients are an increasingly difficult population to reach via  traditional outreach methods (telephone calls and mailings). It has been particularly  challenging for health plans that serve Medicaid recipients to make improvements in the  outcome  measure of Postpartum Care, which involves a postpartum visit to a health care  provider four to eight weeks after giving birth. A postpartum visit is important because it  is an opportunity for the provider to assess overall health and well – being, as well a s  specifically examine a mother’s health related to medical complications of childbirth,  breastfeeding, postpartum depression, and sexuality and family planning. The visit is also  a chance for follow – up and management of chronic health conditions. For many women  on Medicaid, the postpartum visit may be their last opportunity for a preventive health  care visit before they lose eligibility and become uninsured.

Objective: Evaluate the feasibility and appropriateness of utilizing text messaging as an  outreach communication strategy to increase postpartum visit rates among members of a  Medicaid managed care health plan in Minnesota.

Methods: A critical literature review, as well as data analysis of the target population  was completed. In addition, several operational issues related to text messaging were examined, including HIPAA compliance, text messaging best practices, text message  content, and platform options and costs.

Results:  Young adults under the age of 30, as well as low-income and minority  populations, are among the highest users of text messaging. These demographic groups  comprise the core membership of this target population. Cell phone use is nearly  universal among these groups, and the prevalence of wireless – only households continues  to increase . Population – level data, internal managed care organization member data, and  peer-reviewed literature all show support for text messaging as an appropriate, cost effective, and successful communication method to provide postpartum visit reminders, increase rates of compliance, and improve the health of postpartum Medicaid recipients.

Conclusions: The information gained through the compilation of this technical report has  the opportunity to inform a future text messaging pilot program not only in a Medicaid managed care organization, but also more broadly, in other public health and health care  related settings that seek to improve health outcomes in high-risk, underserved women,  children, and families.