CenCal Health Improves Performance in Timely Postpartum Visits for Member Moms
Early in the pandemic, CenCal Health, the Medi-Cal health plan with over 200,000 members on California’s central coast, launched an innovative program for San Luis Obispo County named Healthy Mothers Healthy Families. The purpose of the program is to increase the rate of timely postpartum appointments for CenCal Health members who have recently delivered babies in SLO County. These medical appointments are vital in the early detection of serious, often life-threatening health complications like postpartum hypertension, infections, blood clots, hemorrhage and depression. According to the Centers for Medicare and Medicaid Services, an estimated 40% of women enrolled in Medi-Cal do not get timely postpartum care after having a baby.
The Healthy Mothers Healthy Families program works like this: each week, CenCal Health personnel reaches out to SLO County members who delivered a baby in the last 10 days, to enroll them in the program. Case managers contact the new enrollees to screen them for postpartum depression and help set up their medical appointments and any other services (like transportation) deemed necessary for an optimal health outcome. Tracking the appointment date and making sure the appointment was kept, CenCal Health then sends the new mom a gift basket of products that are useful in caring for herself and her newborn. The program has resulted in the successful contact of 68% of the targeted members, with postpartum checkups subsequently scheduled. Of those new moms, over 95% attended their appointment.
“Healthy Mothers Healthy Families supported health equity for new mothers during a public health emergency through comprehensive case management,” said Dr. Karen L. Hord, CenCal Health Deputy Chief Medical Officer. “We focused on perinatal and postpartum mood and anxiety disorders in our outreach due to the extra mental health strain the pandemic has put on new moms.”
As the Medi-Cal health plan for both Santa Barbara and San Luis Obispo counties, CenCal Health is required by California’s Department of Health Care Services to improve performance by designing programs that boost members’ access to care. In December 2019, CenCal Health identified a geographic disparity between SLO County and SB County. For health plan members in SLO County who had recently delivered babies, the rate of timely postpartum appointments was lower than those of members who were new moms in SB County.
To rectify this gap in care, CenCal Health developed Healthy Mothers Healthy Families, rolling out the program in August 2020. In spite of the COVID-19 restrictions, the gap was closed by mid-2021 with postpartum visits now on par with Santa Barbara County. In both counties, CenCal Health now ranks in the top 5% of Medicaid plans nationwide for postpartum care.
“Through our case management efforts, we worked to ensure our new moms in San Luis Obispo County knew that getting postpartum care was still safe and recommended during the COVID-19 crisis,” said CenCal Health CEO Marina Owen. “CenCal Health is gratified that our Healthy Mothers Healthy Families program is an ongoing success.”
About CenCal Health
CenCal Health is a community-accountable health plan that partners with over 1,500 local physicians, hospitals and other providers in delivering patient care to close to 210,000 members – about one in four residents of Santa Barbara County and one in five residents of San Luis Obispo County. A public agency, the health plan contributes approximately $50 million a month into the local economy, primarily through payments to healthcare providers who serve its membership. Established in 1983, it is the oldest managed care Medicaid plan of its kind in the nation. View its annual Community Report at cencal2020.org
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