The state of Arizona is launching a technology outreach strategy to help Medicaid beneficiaries better manage their illnesses, including a mobile app. Experts say the initiative's success will vary greatly for a population that might not have smartphones.
Gov. Doug Ducey, a Republican, announced the effort Monday, but released few details other than that the strategy involves the use of apps, texts and an online portal.
Through these channels, patients would receive reminders about appointments, access chronic disease management tools, and find primary care doctors or urgent care locations.
The state says these features will ensure patients get timely care and better management of their illnesses—while protecting taxpayers from paying for missed appointments, unnecessary emergency room visits and avoidable hospitalizations.
But experts say that mobile apps may not be the way to go.
“The majority of Medicaid patients, from what I understand, have economic issues, and an app would require a smartphone,” said Alan Stern, vice president, healthcare solution sales at GoMo Health, a mobile engagement company.
The concept of using an online portal to reach Medicaid beneficiaries has also been slammed by stakeholders familiar with the population. When the CMS suggested managed Medicaid plans create an online grievance system as part of a recent rule making, payers dismissed the idea.
“The Medicaid population does not generally have widespread access to computers,” Health Net, a plan that oversees the care of 1.7 million Medicaid beneficiaries across the states of Arizona and California, said in a comment. “The implementation of an online system is not likely to garner a significant level of activity by beneficiaries.”
Indeed, some moves like Arizona's have failed. In January, Michigan launched the Medicaid mobile health app, myHealthButton as well as an online portal. Both were designed to promote connectivity between patients and providers and achieve the same cost-cutting measures Arizona wants.
But to date, the app has only been downloaded more than 3,500 times collectively from Apple's App Store and Google Play, according to Jennifer Smith, a spokesperson for the state's Department of Community Health.
She adds that the app is only actively used by over 1,500 Michigan residents while the state has more than 2 million people enrolled in its Medicaid and Child Health Insurance Program, according to the CMS.
Users appear to not be sold on the app. It has 25 reviews on Google Play and nearly all are negative, with 16 users giving it one star.
“Junk, installed this app and signed up. Haven't been able to log in once and my account has been locked for 3 days,” one commenter says. “When I tried to reset the password it said my answers were wrong. Waste of time.”
There is one form of technology-based engagement that has shown success: texting. While many Medicaid beneficiaries may not have access to a smartphone, most likely have at least a basic phone thanks to SafeLink programs that provide cell phones to low income individuals, Stern said. His company has helped numerous Medicaid plans reach beneficiaries via text to help them stay on top their care.
Last year, Montefiore Medical Center, an academic medical center and University Hospital for Albert Einstein College of Medicine in New York launched a text-messaging trial targeted at 67 Medicaid beneficiaries whose health care in particular is costly to the plan. The mobile health startup is called Sense Health.
By the end of the experiment, it noted a 40% increase in self-reported adherence to appointments, a 12% increase in medication adherence.
“We absolutely believe that technology has the power to improve care and outcomes across socioeconomic levels,” said Pooja Shaw, chief operating officer at Sense Health.
