Texting new mothers to improve postpartum care, a partnership between UMass Medical School and MassHealth

May 20, 2015

More than a thousand pregnant women and new moms in Massachusetts are now able to receive appointment reminders and learn about nutrition, safety and other postpartum issues – via text – through an innovative partnership between UMass Medical School and MassHealth. 

“We want to do everything we can to help mothers give their newborns the best start possible, and providing education can help,” said Dan Tsai, assistant secretary of MassHealth. “This new tool uses simple texting to give tips like the importance of exercise, proper car seat installation, and scheduling regular checkups for both mom and baby. We are proud to offer it to our members.”

The messages, which are part of a free national Text4Baby program, started going out to women who are members of MassHealth, the Massachusetts Medicaid program, in September 2014. More than 1,400 pregnant women and new moms have signed up to receive the messages. The texts include information on immunizations, nutrition, flu, oral health and safety, as well as reminders about postpartum appointments.

When women sign up, they are asked to respond to a survey asking about insurance coverage. Text4baby provides program managers at UMass Medical School with a monthly report that includes the percentage of participants who are MassHealth recipients or applicants.

“We worked with one of the co-founders of Text4Baby, the National Healthy Mothers, Healthy Babies Coalition to replace some of the national web pages and phone numbers with local ones,” said Rossana Valencia-Hoang, MPH, project director in the Office of Clinical Affairs at UMass Medical School’s Commonwealth Medicine division.  

Text4Baby is just one component of the MassHealth Postpartum Visit (PPV) Quality Improvement Project, financed with a portion of a $1.8 million Adult Medicaid Quality Grant from the Centers for Medicare and Medicaid. Massachusetts is one of 26 states to receive the grant. The project seeks to increase the number of women enrolled in MassHealth who receive a postpartum visit three to eight weeks after delivery. Although postpartum visit rates among mothers who are enrolled in MassHealth have increased over time, a significant percentage of mothers still do not receive the care they need. In 2013, 69.8% of new mothers covered by MassHealth received a postpartum visit.

After delivering their babies, some women may not have another doctor’s appointment until they’re pregnant again, which makes the postpartum visit a critical point in their health care, Valencia-Hoang said.

Postpartum visits provide an important opportunity to discuss such matters as birth control and breastfeeding, and address other concerns that could affect a woman’s ongoing physical and emotional health, including high blood pressure and postpartum depression. The American Academy of Pediatrics and American College of Obstetricians and Gynecologists both recommend that women receive a postpartum visit within the first eight weeks after delivery.

In addition to the texting program, the postpartum project also includes training community health workers across Massachusetts about health care between pregnancies and distributing a provider bulletin to health care professionals about how to engage patients and improve postpartum visit rates.

In partnership with the Center for Health IMPACT, part of UMass Medical School’s MassAHEC Network, 64 community health care workers participated in a free 18-hour training over three days in August, September and October 2014. The training, which aims to increase women’s access to care and reduce disparities in health care, was offered in four areas of the state: Worcester, Fall River, Holyoke and Boston. Additional training will finish this week in Springfield and another will be held in Worcester in June.  

The grant program, which began in 2012 and was slated to end in December 2014, received a no-cost extension from CMS for another year and will continue its efforts through 2015.