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.