Overcoming barriers to perinatal care in Medicaid populations: The Healthy Mom postpartum program

Background

The postpartum visit is an important opportunity to address medical complications, breastfeeding, postpartum depression, and inter-conception planning.  Rates of attendance at this visit remain consistently low among Medicaid beneficiaries compared to commercial health plan members.   To improve access to postpartum care among Medicaid managed care beneficiaries in a metropolitan area, we implemented the Healthy Mom program, a patient-focused telephonic outreach program. 

Methods

Mothers who had recently delivered received a telephone call from a bilingual, bicultural Health Education Advocate, who educated them on the importance of postpartum visit, assisted with appointment scheduling, and provided transportation and interpreting services, if needed.  The Health Education Advocate also offered a non-monetary incentive to participants for attending the visit.  Attendance was confirmed via phone call to the doctor’s office.

Results

In 2013, the rate of attendance at the postpartum visit among women who received an outreach call (n=648) was 82.8%, compared to the overall rate of attendance of 49.2%.  The trend continued in 2014, with 86.0% of program participants (n=1042) attending their appointments. (Overall rate for 2014 will be available summer 2015).  Results indicate that telephonic outreach, combined with a non-monetary incentive, was successful in increasing rates of attendance at the postpartum visit.

Conclusions

The Healthy Mom Postpartum Program has shown to be an effective method for outreaching to low income women in a metropolitan area.  This model, which requires minimal resources as a sustainable long-term intervention, can be applied in other settings to efficiently assist under-resourced women in accessing healthcare services.