Many Medicaid members come from disenfranchised communities or are of low socioeconomic status. They may not have the opportunity to have their own baby shower due to financial constraints as they can be costly. However, baby showers are a societal norm where new parents are showered with gifts and emotional support. Optima Health wanted to make sure their pregnant members had a chance to feel celebrated. They identify pregnant members to invite to these baby showers through not only claims data but also state data and survey responses.

State data
Optima Health, like most Medicaid managed care organizations, receives monthly files from their state’s health department which includes newly eligible and fully enrolled beneficiaries, who qualify for Medicaid because they became pregnant. As soon as the health plan receives contact information for these individuals, they immediately outreach. This outreach is completed via Optima Health’s welcome materials, which includes onboarding and benefits information. Additionally, the new members will receive a call from the health plan reiterating their benefits plus eligible services/programs like the baby showers hosted all around Virginia.

Survey responses
At the start of each plan year, Optima Health has their Medicaid members complete a questionnaire which screens for many things, one being if the member or someone in the household is pregnant. Using these data, the health plan will directly outreach to its pregnant members via phone by congratulating them and encouraging them to not delay care by offering an incentive for going to a prenatal and/or postpartum appointment. Optima Health staff will also use this opportunity to promote the baby shower and entice members to attend by sharing that they will have the chance to win prizes like a stroller and diapers.

Note: These showers were originally hosted in-person. However, Optima Health quickly pivoted to a virtual format due the pandemic. They plan to transition the showers to a hybrid format once the public health emergency (PHE) ends.

Optima Health has a staff member dedicated to organizing their baby showers. This employee is also responsible for maintaining relationships with hospitals and community-based organizations (CBOs).

Collaborating with hospitals
Optima Health will collaborate with a Sentara Healthcare hospital in each community for a designated space to host the event. They’ll additionally request a couple hospital providers (physicians, nurses, etc.) to participate in the shower. This is important because one goal of these baby showers is to make members comfortable with the health care providers and facilities for when they give birth. In communities where there are no easily accessible Sentara Healthcare facilities, Optima Health will team up with an out-of-network hospital or host the event at a community center. Even when the baby showers are virtual, Optima Health involves providers in the event as shown on the right.

Connecting members to CBOs
Many of Optima Health’s pregnant, low-income Medicaid members need social support services. Optima Health invites CBOs to present at the showers to remind members to utilize the free resources. No one community has the same social needs, which is why each shower is planned to reflect the needs of individual regions. In areas with food insecurities, Optima Health will request SNAP or WIC to speak on the importance of healthy eating and provide breastfeeding tips. The health plan will also invite leaders from local faith-based organizations to create a sense of community and support.

Why a welcoming environment is crucial for Medicaid members
Many Medicaid members come from impoverished communities or lack economic and social stability. They may not have the opportunity to have their own baby shower due to financial limitations or lack of social support. Studies have shown having social support during pregnancy positively affects the mother’s emotional well-being and lessens her chance of postpartum depression. Pregnant women with little or no social support are also more likely to delay or avoid prenatal care.

Have fun while learning
Optima Health’s main goal was to design an event that was informational and engaged members. However, they realized just instructing members how to prepare for the big day and sharing available community resources was not going to drive behavior change. They needed to make the event captivating, so members are more attentive to the information. The health plan also wanted members to feel celebrated and supported. To do this, Optima Health incorporates traditional baby shower games, activities and food. They give members the space and time to get acquainted with and bond with other moms. Members are also allowed to bring their care givers. In the past, members have brought their significant other, spouse, a relative and even other children. Like a traditional shower, attendees play game and can win prizes like a stroller.

As previously mentioned, health care providers from the hosting hospital walk expecting mothers and guests through the birthing process. Members go on a tour of the labor and delivery unit. These two parts of are always apart of every shower agenda as it helps to alleviate members’ fears and get them comfortable with their physician and the hospital. Nontraditional practitioners, like midwives and doulas, are also invited inform members of alternative birth options. Other agenda items may include discussions on:

• Importance of getting prenatal early
• Returning for postpartum care
• Breast feeding tips
• Safe sleep
• Pediatric CPR

For in-person showers, Optima Health staff on-site assist members with scheduling prenatal and/or postpartum appointments.

The day wraps-up with attendees getting party favors which may include diapers and baby books (to encourage early reading).