How virtual support increases engagement and improves health outcomes for Medicaid population
The state of maternal health in the United States
Nearly 7 million women in the United States live in healthcare deserts with little to no access to maternity care. Only about a quarter of all families meet The American College of Obstetricians and Gynecologists (ACOG) recommendation of exclusive breastfeeding for 6 months (21% for Hispanic families). Because of this, providers and systems are being called to extend the postpartum period, seen as 3 months, up to a full calendar year. A large portion of that postpartum period is being screened and monitored for any adverse outcomes. ACOG recommends all women should be screened for postpartum depression at least once during the peripartum period with a follow-up postpartum screen in at-risk women. But how can they be screened when only 60% of women attend the 6-week postpartum visit?
For a country that has the highest rate of maternal and infant mortality for a developed nation, we have a serious problem.
SimpliFed recently sat down with Dr. Quratulain Zeeshan to discuss how layering in virtual care has helped her patients and her practice meet breastfeeding and mental health screening recommendations. This webinar featured Andrea Ippolito, Founder and CEO of SimpliFed along with Dr. Quratulain Zeeshan, Director of Quality for Women’s Health at Sun River Health, New York’s largest Federally Qualified Health System.
Barriers to care
There are so many reasons why women aren’t receiving the care they need. Common access barriers like transportation, affordability, and childcare, compounded even more for Medicaid populations, prevent them from going. Recent studies show that women with adverse pregnancy outcomes such as postpartum depression or preeclampsia have a much higher risk of mortality 40 years after birth. Reaching them during this critical period could save their lives.
So where do we start?
First, we can understand that 40% of an individual's overall health is impacted by social drivers such as where they grow up, where they work, and where they have access to healthcare. Comorbidities or adverse outcomes are higher in populations whose social drivers create barriers. For Medicaid populations, one of the biggest is transportation. For many families, even within a large city, it can take multiple subway stops, buses, and more to get to their clinic. These families may even rely on partners for transportation because they don’t drive themselves.
So now they’re also suffering a financial loss because of needed time off of work to take the hours trek. If you ask a family to choose between a postpartum follow-up appointment or making money to feed their family, it isn’t surprising what they will choose.
Most OBGYN clinics are also overbooked with fewer resources to meet the increasing demand–especially as comorbidities and more follow-up is needed. Patients who need to be seen are left waiting hours in a waiting room. Another reason why they may choose to not attend.
Benefits of virtual care
Virtual care means access to data and insights that can help inform how providers care for their patients. Virtual care not only bridges the language gap with providers and staff engaging with patients in their preferred language but can also engage in the technology that patients feel most comfortable with. Access to consistent care forms trust with patients, but layering in virtual care and monitoring can also create efficiencies within a healthcare system.
But how do we implement that into a health system?
Firstly we begin by realizing virtual care is a necessity for families. If the postpartum period is a year-long, access to consistent appointments needs to be convenient or it won’t happen. Listen to your patients. They will tell you that access to virtual care matters. Giving the option of meeting with your provider from home opens up possibilities for a family, but also for a clinic. It eases provider burden and long wait times. It also improves in-person engagement rates and important screening adoption.
Nearly 20% of women are diagnosed with some form of perinatal mood and anxiety disorder, but only 17% of women are screened. If that is left up to the in-person provider and patients don’t come, what happens? By embedding virtual appointments within a typical care pathway, patients are automatically screened and served. We eliminate the common barriers, preventing essential care.
It isn’t just the knowing that patients need care, however, it’s helping them get it that counts. Because layering in virtual care eliminates gaps and offers consistent monitoring and communication most patients are more apt to attend in-person appointments when needed. They’ve taken a part in their care, they are engaged. Screening rates are higher and breastfeeding rates are higher. We have better health outcomes.
Q&A
1. Can you talk about the cost benefits of partnering with a virtual care company like SimpliFed?
Before working with SimpliFed we saw many patients struggle with lactation and would actually come to the emergency room with mastitis symptoms because they couldn’t get to an appointment or a health center, find a convenient time, or now feel too sick. Not only is that a cost burden, but also that mother is being exposed to several infections and possibly bringing it home. Causing more sick visits. Since working with SimpliFed none of my patients have come through the ED because a virtual team is just a call away.
2. What does the workflow look like for your patients?
SimpliFed is part of our 36-week order set which means every pregnant patient is referred over for lactation services. Patients of course have the autonomy to decide if they want the services but we do encourage them to meet with SimpliFed early as it’s so important to be prepared. After delivery, our patients continue to meet with SimpliFed for any issues that arise with feeding. Our patients are also screened for postpartum depression which is so essential to making sure that we (the at-home team) are providing the right level of care. We have access to all appointment notes and can escalate as needed.
Listen to the full recording here:
