CalOptima is one of the Medi-Cal plans in the state to receive special authorization from the Department of Health Care Services (DHCS) to send text messages to members. As a result, CalOptima is using text campaigns to boost COVID-19 vaccination rates among communities on Medi-Cal.
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DCHS data has shown that vaccination rates among Medi-Cal beneficiaries lag far behind other state residents. As of Sept. 19, 77.6% of all Californians had received at least one dose of the vaccine, compared to 53.3% of Californians on Medi-Cal.
Through text messaging campaigns that started in March 2021, CalOptima has been able to communicate critical COVID-19 information to their members. Much of these text messages contain content to counter vaccine misinformation, share vaccine access information, and encourage unvaccinated populations, particularly those on Medi-Cal, to get vaccinated.
CalOptima Medi-Cal vaccination rates as of September exceeded overall Medi-Cal vaccination rates in every age group. Pshyra Jones, MPH, director of population health management at CalOptima, says these text campaigns have played a huge role in their success engaging with a historically hard-to-reach population.
“We did a survey of our membership and their demographics and we learned that at least 80% of our members had access to smartphones. So this is why text messaging has become such a very efficient way for us to communicate important, time-sensitive information … Historically, [with] Medi-Cal communities and plans, we have done the majority of our communication to members via mail. We also know that [the] physical address[es] [of] our members [are] not always accurate — the Medi-Cal plans receive a lot of mail. People usually carry their phones with them … and that’s why I feel like this is a much more effective way of communicating with our members.”
CalOptima is required to send their text content to DHCS for review and approval before disseminating it out to their membership. As part of the approval process, DHCS ensures that plans are following the emergency use authorization per the Telephone Consumer Protection Act (TCPA), which provides exceptions for rules surrounding text messaging to members in the case of a public health emergency.
Content in the text messages must remain at a sixth-grade reading level and there are several required threshold languages to which the information must be translated. Jones stated:
“The theme was to really share content that was out in the media, or we took information from the CDC website and repurposed it in layman’s terms.”
In addition to the text campaigns that address vaccine hesitancy by countering misinformation and providing factual information from the CDC, CalOptima has conducted a COVID-19 vaccine member health rewards program in further efforts to boost vaccine rates. The program allows eligible CalOptima members aged 12 and older to receive a $25 gift card for each COVID-19 dose received, totaling up to $50 in gift cards. The gift cards are sent to members after CalOptima receives vaccination confirmation through the data exchange.
Jones said CalOptima will continue to use the text campaigns, rewards program, and other messaging strategies to boost vaccine rates, especially in the most vulnerable communities on Medi-Cal.
“We already know that there are a couple of populations where we need to focus. We know that our American Indian [and] Alaska Native population is slightly below our other communities in their vaccine rates, also our African American … both those populations have vaccine rates around 41% or 44% compared to some of our other ethnic groups. So we’re going to be doing some targeted messaging that we hope resonates with those communities to improve the rates for those communities. Those are our most immediate efforts, that’s where we’re focused right now.”
Jones also asserted that health plans should be allowed to communicate with their members via text outside of a public health emergency, stating:
“We’ve … heard from our members through surveys and other communication models that they would like to hear from us via text or email and so forth, because that’s how we communicate today. So we don’t feel like health plans should be exempt. It’s timely communication. If we can pivot from COVID, there are so many other things that we can do around texting. We can talk to our members about their gaps in care, give them some reminders or tell them about the importance of having their kids in for those well-child visits, or getting those preventative screenings.”