(Updated, 5 p.m., Aug. 21)
At 6.1 for every 1,000 live births, the infant mortality rate in the United States ranks No. 26 in the world, below many countries in Europe, according to 2010 data from the federal Centers for Disease Control and Prevention. It would seem that an intervention is in order, one born of the Information Age.
As if on cue, digital assistance programs began showing up in Rhode Island. The first came in 2010, courtesy Neighborhood Health Plan of Rhode Island for its members enrolled in Bright Start, the insurer’s healthy pregnancy, healthy baby program.
Called Text4baby, it was developed by a broad coalition of for-profit and nonprofit enterprises, including Zero to Three, a national nonprofit dedicated to the health of babies and toddlers, with support from the March of Dimes, the American Academy of Pediatrics and the U.S. Public Health Service, as well as Voxiva, The Wirelss Foundation and Grey Healthcare Group, among other organizations.
Neighborhood members who were participants in the state’s Medicaid program, Rite Care, receive weekly communication about nutrition, prenatal care, developmental milestones and the like, said Tom Boucher, Neighborhood’s senior manager of communications and public affairs.
Since its February 2010 launch, 1,564 Rhode Islanders, many of them insured by Neighborhood, have enrolled in Text4baby, according to Lindsay Handelsman, a spokeswoman for Zero to Three.
In late 2011 UnitedHealthcare of New England brought its own app to the market, Baby Blocks. Currently, the Baby Blocks app is available only to United’s RIte Care members. Compatible with iPhones, Androids and other smartphones, Baby Blocks includes email appointment alerts, wellness-related text messages, direct access to maternity nurses, and incentives when participants comply with pre-determined benchmarks. As a woman proceeds through pregnancy and the baby’s first year, meeting certain benchmarks and unlocking “blocks,” she can earn a gift certificate, diaper bag, thermometer, or other such rewards.
“We are meeting a need that we know exists. Pregnant women and new mothers were finding it overwhelming … keeping up with numerous prenatal, post-partum and well child visits, said Dr. Vidya Raman-Tangella, head of UnitedHealthcare Innovation Center of Excellence. The app – designed to simplify the entire pregnancy and child-rearing process – is enormously popular; according to United. Company research states that nearly 98 percent of the nation’s 42,000 Medicaid beneficiaries using it are satisfied with Baby Blocks.
Rhode Island was among the first of the 16 states currently offering Baby Blocks for their Medicaid enrollees. Since Rhode Island’s November 2011 launch, approximately 1,200 RIte Care participants have completed Baby Blocks, according to the insurer, which continues to update the app to make it more engaging for pregnant women and new parents.
The state expects health insurers to work to improve their members’ health, and anything that incentivizes folks to do the right thing is positive, said Deborah Florio, Children’s Health Insurance Program director for Rhode Island Medicaid. Although United doesn’t yet have the data on improved delivery or post-partum outcomes, or cost savings, Florio said, “[United] saw it as a positive and potential cost savings.”
Anecdotally, the app is an effective tool. “Baby Blocks is very helpful [in supporting] new moms,” said Rocquelle Hazard, 25, of Providence, who said the program made it easier for her keep up with her prenatal medical appointments.
Given the sizable amount of data needed for analysis, Raman-Tangella predicts that understanding Baby Blocks’ effectiveness won’t be possible for one to three years. But the company believes in the product nonetheless. In 2014, United launched an employer version of Baby Blocks, and the program is currently available to self-insured companies with more than 5,000 employees nationwide.
United’s Rhode Island rankings for prenatal and post-partum care changed after launching Baby Blocks. Compared to all of the nation’s other Medicare programs, its prenatal care ranking jumped from the 50th percentile in 2010 to the 90th percentile in 2015. Its post-partum care ranking rose from the 50th percentile in 2010 to the 75th percentile in 2015, according to data Florio provided. United’s well-child care ranking remained in the 90th percentile.
Does Raman-Tangella attribute these improvements to Baby Blocks? “Baby Blocks and our maternity support programs all contribute to a greater engagement,” said Raman-Tangella, which certainly “can be a contributing factor, but not the only factor in seeing those positive data.”
Tufts Health Plan has no present plans to develop such mobile apps, said Sonya Hagopian, vice president, corporate communications and public relations. Last month, Blue Cross & Blue Shield of Rhode Island, in collaboration with Walgreen’s, launched a mobile app for patients undergoing fertility treatments, reported Kyrie Perry, the company’s public relations specialist. •
