Go Before You Show Health Plan of San Mateo &

1. Go Before You Show  Health Plan of San Mateo & San Mateo County Health System Family Health Services Division Mary D. Giammona, MD, MPH and Liliana Ramirez, MPH What’s Next The Problem Interventions HPSM and San Mateo County are committed to ongoing spread of the Go Before You Show campaign and also work with community clinics to encourage timely entry into prenatal care. Our Prenatal Social Marketing Committee will continue to distribute materials to clients through grass-roots outreach efforts. We are currently developing a campaign specifically targeting Tongan and Samoan women, where there still seems to be a lag in timeliness to entry to prenatal care. This campaign should be ready to launch in Fall 2011. • First Intervention We Tested: • Our Prenatal Social Marketing Committee had made efforts to increase community awareness of temporary Medi-Cal by developing a brochure on how to access prenatal care for women without insurance. Although temporary Medi-Cal was promoted, the committee felt more needed to be done. • How We Tailored Care with New Intervention: • Developed the “Go Before You Show” campaign, • Redesigned the temporary Medi-Cal brochure, • Developed posters targeting Latina, African-American and Pacific Islander women, • Created toll-free line, website, bus ads, movie theater ads, a billboard, and grass roots outreach within community agencies all focused on message of “Go Before You Show.” • A disparity in timely entry into prenatal care exists among Latina, African-American and Pacific Islander compared with Caucasian women in San Mateo County. There is a lack of awareness about presumptive eligibility (PE)/temporary Medi-Cal among women in the community. • San Mateo County statistics show that the proportion of births in the county with adequate and timely prenatal care is below the Healthy People 2010 target of 90%, thus 10% do not receive timely care. San Mateo County data indicate that Latina (17.4%), African American (17.4%) and Pacific Islander women (33.4%), have the highest percentage of births without timely prenatal care in comparison to Caucasians (7.7%). Lessons Learned • The most significant lesson learned was how powerful and effective community collaborations can be. The support of all the members of our Prenatal Social Marketing Committee led to an extremely successful grass roots outreach effort in each of the communities with disparities. • Ads inside buses generated the most response. The least successful marketing effort for HPSM members was through the movie theater ads; however, we do not know how much of an impact that may have had on the general public. • We look forward to further analysis of our results, as more data becomes available. Goals and Objectives Measuring Improvement • Goal: • HPSM and San Mateo County intended to increase the rate of timely entry into prenatal care by at least 5% in 2011 for Latina, African-American and Pacific Islander women to decrease the health disparity that exists in these communities; to be done by educating women about accessing timely prenatal care through the promotion of the Go Before You Show campaign. • Objectives: • Increase awareness about importance of timely prenatal care in San Mateo County. • Increase timeliness of prenatal care among Heath Plan of San Mateo (HPSM) members. • Improve HPSM’s Timeliness to Prenatal Care 2011 HEDIS rates to 80% for the groups above, identified with disparities. • What We Measured: • Distribution of materials--Quantity • Change in Enrollment into PE/temporary Medi-Cal numbers • Number of calls to toll-free number • Number of women enrolled in HPSM Prenatal Care Program who started care in 1st trimester • What We Found: • Approximately 20,000 brochures and 2,000 posters were distributed within San Mateo County. • We saw a notable increase in the number of presumptive eligibility enrollments at the PE provider offices. We collected PE enrollments from 6 provider offices pre-campaign and saw the overall enrollment double in enrollments post-campaign. • HEDIS • The 2011 HEDIS rate for Timeliness of Prenatal care (83%) dropped slightly overall compared to 2010 HEDIS rate (85%); however, data showed that, women who started prenatal care in first trimester by ethnicity increased for: Asian/Pacific Islanders (84% vs 66.6%); it stayed about the same for African-Americans (81% vs 82.6%), and decreased for Latinas for unclear reasons, which we will continue to pursue (75% vs 82.6%). My Organization The Health Plan of San Mateo (HPSM) is a non-profit managed care health plan that has provided health coverage to San Mateo County’s underserved residents since 1987. Currently, HPSM has approximately 102,000 members with 42% of the total membership identifying Spanish as their preferred language. HPSM improves the health of our members through high quality and preventive care. We have a vision, that healthy is for everyone. The Family Health Services Division is part of the San Mateo County Health System whose mission is to increase the longevity and quality in people’s lives by preventing health issues before they occur, protecting the public’s health, providing services for vulnerable populations and partnering to build healthy communities. Contact Me: For more information, contact me: Liliana Ramirez, MPH 650-616-0050 Liliana.ramirez@hpsm.org