Improving Maternal and Behavioral Health for Medicaid Members

Twill’s Government Programs team recently attended the Medicaid Innovations Forum and gained valuable insights on maternal health equity. In this post, we’ll detail our learnings and outline Twill’s dedication to positively impacting pregnant and postpartum Medicaid members' outcomes.

Twill’s Takeaways

Using AI to Tackle Social Determinants of Health (SDoH) Challenges

SDoH may limit someone’s access to important resources for maternal health. AI can address this by personalizing outreach, boosting member engagement, and improving accessibility of helpful resources. Twill has developed a clinically-trained AI coach, Taylor, that offers personalized support and guidance along with science-backed activities. AI also powers our recommendation engine with relevant pregnancy related articles based on the member’s due date, and tip cards with a diverse Medicaid pregnancy audience in mind.

The Importance of Targeted Interventions in Maternal and Behavioral Health

The need for targeted and early solutions to maternal behavioral health concerns such as emotional stressors during pregnancy is critical. By addressing these, our maternal health solution is designed to impact maternal outcomes for members, reducing preterm births¹ and even the necessity for C-sections².

Recent studies show that the period surrounding pregnancy is associated with a greater likelihood of new or recurring maternal psychiatric disorders. Approximately 27.5% of pregnant people on Medicaid have prenatal depression, with Black women, single women, and those with other children having a higher risk of depression^7, yet, only 20% of new mothers in America are screened for postpartum depression³. With over 80% of pregnancy and postpartum-related deaths considered preventable by the CDC⁴, it's crucial for us to take action. These alarming statistics highlight the critical need for promptly identifying maternal warning signs, administering timely treatment, and ensuring the delivery of respectful, high-quality care.

In a recent launch with a Medicaid health plan, Twill’s maternal health solution engaged hard-to-reach members early in pregnancy, identifying up to 50% of activated members before the health plan was aware of their pregnancies. Additionally, 66% of the Medicaid members activated on Twill who self-reported a due date were in the first trimester of their pregnancy. These statistics highlight Twill's effectiveness in reaching and engaging more Medicaid members early in their pregnancy journey, enabling them to get access to the support they need sooner, leading to improved outcomes for both pregnancy and the postpartum period. What’s more, 92% of the Medicaid health plan users activated by Twill were acquired through engagement with online direct-to-consumer marketing or social media platforms, indicating our ability to connect with members where they already engage online.

Examine and Acknowledge Racial Inequities to Improve Health Equity

In the U.S., non-White communities tend to fare worse in terms of SDoH.⁶ To address these inequities, Twill aims to improve accessibility of care and resources through digital access to care and dedicated content for diverse populations.

Twill’s integrative features promote accessible, well-rounded patient care that can guide members to health services like OB/GYNs, clinics, and local resources. With one-click calling, members can quickly reach in-network doctors such as PCPs or pediatricians. Twill also creates dedicated content for Black members in our Black Maternal Health Hub on Twill Care, featuring tips and recommendations from Black OB/GYNs and doulas as well as resources for self advocacy in healthcare settings.

While few other digital health companies have explicitly explored how people from different racial and ethnic backgrounds engage with their products, Twill is committed to asking tough questions to advance health equity. In a recent study of Twill’s digital wellness product, we found that the racial and ethnic background of members were comparable to the racial and ethnic makeup of the US population. More importantly, that engagement levels and mental health improvements were consistent across all racial and ethnic groups⁵. While it's crucial to reduce racial gaps in access to care, we also focus on improving health equity through greater health literacy.

Moving Forward

At Twill, we're not only envisioning a future where maternal health equity is a reality—we’re actively building it. Through innovative solutions, partnerships, and a relentless focus on the needs of pregnant Medicaid members, we are able to improve the maternal and behavioral health journey, one member at a time.

Learn more about how Twill creates a path to healthier pregnancy and postpartum journeys here.

1. Coussons-Read, M. E. (2013). Effects of prenatal stress on pregnancy and human 
2. development: mechanisms and pathways. Obstetric medicine, 6(2), 52-57.
3. Staneva, A., Bogossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women and birth, 28(3), 179-193.
4. Mundell, Ernie . “Mental Health Issues a Prime Driver of Deaths for New Moms: Study.” USNews, 26 Feb. 2024, www.usnews.com/news/health-news/articles/2024-02-26/mental-health-issues-a-prime-driver-of-deaths-for-new-moms-study. 
5. Centers for Disease Control and Prevention. (2023, April 3). Working together to reduce Black maternal mortality. 
6. Twill Happify Internal Racial Studies report
7. Hill, L., Ndugga, N., & Artiga, S. (2023, March 15). Key Data on Health and Health Care by Race and Ethnicity. Kaiser Family Foundation.
8. Benatar, Sarah, et al. “Prenatal Depression: Assessment and Outcomes among Medicaid Participants.” The Journal of Behavioral Health Services & Research, vol. 47, no. 3, 25 Feb. 2020, pp. 409–423, https://doi.org/10.1007/s11414-020-09689-2.