P2.Q329: Impact of a Virtual Maternity Care Program on Postpartum ED Visits in Medicaid-Enrolled Infants

Background: The postpartum period is a critical time for maternal and child health, often marked by an increased need for healthcare services. Access to timely and appropriate care remains a challenge for many during this period, which can lead to a high rate of emergency department (ED) visits. Programs that offer support for post-birth transitional care have been shown to decrease avoidable ED visits (Vohr et al, J Perinatol 2018). Pomelo offers 24/7 holistic telehealth care to support birthing people and infants with access and evidence-based medical, behavioral, and social care between in-person visits and in transitions of care. This study investigated the effect of Pomelo Care's program on the frequency of infant ED visits during the first 60 days of life.

Methods: Infants (N=649) were included if they: (A) were born to a parent enrolled in a Medicaid plan participating in Pomelo Care's virtual maternity program between 1/1/2023 and 2/10/2024, (B) were enrolled in Medicaid, (C) had claims data available through at least 60 days post-birth. Infants were categorized based on whether their parent meaningfully engaged with Pomelo’s services during the same period, as defined as having sent 10 or more messages to their care team. To account for risk, HHS-HCC risk adjustment factors (RAFs) were computed for each infant. The primary outcome was infant ED utilization within the first 60 days post-birth. An IRB waiver of informed consent was obtained.

Results: Infants whose parents engaged meaningfully with Pomelo’s services during the 60 days post-birth had higher risk than those who did not, as measured by HHS-HCC RAF (0.55 vs. 0.37, difference = 49%). They also had a lower rate of ED visits in the 60 days post-birth (4.6% vs. 6.3%, difference = 23%).

Conclusion: Infants whose parents engaged meaningfully with a telemedicine program designed to provide support in the postpartum period were less likely to have an ED visit in the 60 days after birth, despite having higher medical risk. The results of this study highlight the potential of virtual perinatal programs to increase access to care and reduce avoidable ED visits. These results are particularly important for Medicaid-enrolled infants, a population often faced with significant healthcare access challenges.