Patient Engagement, Payers, Health Services

How California could pave the way for text messages in Medicaid

The California Department of Health Care Services (DHCS) has recently issued a policy sketching out how the state’s Medicaid plans can safely use the text messaging technology to connect with members.

Consumer research has shown that 97 percent of Americans text at least once a day and that the texting is the number one mode of communication among people under 50.

For significant swathes of the Medicaid population especially, the mobile phone acts as a central communication device and their portal to internet connectivity. It’s no surprise then, that text messages have emerged as emerged as a preferred option for many patients in how they communicate with their healthcare providers and more consistently engage with their health.

In the Medicaid population specifically, employment and personal challenges may limit the ability to take a phone call to schedule an appointment or ask questions about treatment plans.

A major barrier in the use of text messaging in healthcare has been the Telephone Consumer Protection Act (TCPA), a 1991 law that was meant to guard the public from automated telephonic messages including text messages, by levying financial penalties for the action.

As Abner Mason likes to point out, the TCPA was enacted the same year the first commercial SMS text message was sent and is disconnected to the ways patients engage with their healthcare today. Mason is the CEO of ConsejoSano, a Los Angeles startup that focuses on cultural translation and health engagement efforts mainly in the Medicaid population.

Over the years, the risk associated with TCPA violations has waned, but health plans have been wary of state regulators cracking down on their text message engagement efforts.

In a signal of progress on the issue, the California Department of Health Care Services (DHCS) has recently issued a policy sketching out how the state’s Medicaid plans can safely use the text messaging technology to connect with members.

One out of three people in California are Medicaid beneficiaries and top national managed Medicaid plans providers like Anthem, Molina Healthcare and UnitedHealthcare are active in the state.

“The irony is that health plans are under pressure to boost engagement with their members from the same regulators who are blocking them from using texting to do so,” Mason said. “This move by California can hopefully create a model and help plans agitate in other states they are active in to put in place a clear policy for how they can undertake these campaigns.”

Essentially the new policy allows California initial outreach to patients through text messaging if they submit a form of approval to the regulators laying out the goals and structure of their outreach campaign and how they intend to ensure privacy protections for users and give them a clear opt-out option. The outreach messages must also be available at no cost to the Medicaid member.

Once the campaign is approved, the health plan can continue to run the outreach program repeatedly without any additional regulatory clearance.

Mason describes the policy move as a “game-changer” that will open up the ability of health plans to connect with patient populations traditionally considered difficult to reach.

In the company’s work with Federally Qualified Health Centers and Independent Practice Associations, ConsejoSano has been able to drive major results by using culturally relevant texting campaigns.

One partnership with Borrego Health was able to bring in 15,000 new patients to receive treatment who had not been engaged with their health before. Additionally, the texting campaigns were able to boost their successful appointment rates and drop no-show numbers through appointment reminder campaigns.

Based on the ConsejoSano’s internal data, parents with children between the ages of four and 18 are three times more likely to make an appointment through text messages than a phone call.

“This is really a health equity issue,” Mason said. “If we’re going to meet people where they are, we’ve got to take this step to allow text messaging.”

Picture: ljubaphoto, Getty Images