A Path to Healthier Pregnancy and Postpartum Journeys

Twill provides a digital-first experience to improve the behavioral health and maternal care journey for Medicaid members

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Introducing Twill's Digital-First Medicaid Pregnancy Solution 

We provide maternal health support for healthier pregnancies

Twill offers an easy-to-use, scientifically-designed digital app that enables members to activate healthy behaviors through: digital self-care, support communities (including board-certified experts), human-led coaching, and intelligent connectivity to deliver comprehensive care to Medicaid members. Our solution provides physical and emotional health support during pregnancy and postpartum. Additionally, our configurable solution can help address a member's other needs (i.e SDOH) by directing them to relevant resources through one common access point. 

How we do this: 

1. Finding and activating hard-to-reach pregnant people 

Our industry-leading, direct-to-consumer marketing strategy engages pregnant and postpartum women precisely where they are, online. We identify Medicaid members earlier in their pregnancies than with screening tools or claims alone and maintain strict protocols to protect members’ security and privacy. In a recent case study with a Medicaid health plan, Twill was able to activate 9 out of 10 eligible Medicaid members via direct-to-consumer channels. Additionally 66% of Medicaid members activated on Twill who self-reported a due date were in the first trimester of their pregnancy*.  

2. Engaging and guiding pregnant and postpartum members to personalized health plan resources  

The platform allows for harmonious collaboration with a health plan’s existing investments by screening and referring members to other plan services throughout the maternal journey. This includes relevant state or local resources, which can include health-related social needs resources like food access and housing resources.

3. Driving the most impactful healthy behaviors to prevent downstream health risks and costs 

Developed over the past 10+ years, our digital therapies are built on the  foundation of evidence-based behavior change modalities including Cognitive Behavioral Therapy (CBT), mindfulness, behavioral activation, and positive psychology. Our intervention-based activities have proven to reduce symptoms of depression, stress, anxiety, and may improve overall well-being by improving diet1, exercise2 and sleep3,4,5. 

4. Reducing comorbid symptoms of anxiety and depression  

Twill’s clinically-validated solutions are proven to decrease symptoms of anxiety and depression. Early activation and intervention can lead to downstream improved maternal health outcomes. Twill’s RCT (1.5) showed significant improvement in subjective well-being and anxiety for a variety of populations. We find improvements of 15-26% in subjective well-being and approximately 14-26% in anxiety6. Symptoms of depression and anxiety7 have been linked to worse maternal and birth outcomes (e.g., c-section, preterm birth, and low birth weight8). As a result, improving these symptoms may help to improve some of these pregnancy-related outcomes.

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Partner with Twill, a collaborator in innovation, to drive healthy behaviors and better outcomes for pregnant and postpartum Medicaid members

Existing research shows the critical need to address emotional stressors and behavioral health during pregnancy, which may positively impact other maternal outcomes (e.g., preterm birth9, reductions in c-sections10). Twill partners with Managed Care Organizations to offer a coordinated system that delivers innovative solutions to addressing upstream maternal behavioral health concerns of its Medicaid members. In turn, improving healthy behaviors could lead to several downstream effects including enhancing value for members, informing Medicaid agencies’ long-term objectives and priorities, and improving medical cost savings.

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Existing presence in Virginia

Virginia

Twill currently activates and engages Virginia Cardinal Care members through managed care partnerships in Virginia. Twill has partnerships with nonprofits and community-based organizations across the Commonwealth to provide additional support to underserved communities in need of maternal health support. 

Icon 3_Head Key_large_Heritage BlueACTIVATING MEMBERS earlier in their maternal health journey, and resourcing them with digital-first technology, data, tools and resources. 

Twill activates members through destigmatized, market-tested outreach and communications at any stage of pregnancy and postpartum period, and can direct them to screening. Self-guided digital therapeutics offer mental and physical health support tailored for all phases of the maternal journey. 

Ideas iconPROVIDE EDUCATION, self guided therapeutics to the maternal health community, and access to care.

The platform offers a library of digital resources to address common pregnancy concerns. Educational content is delivered through polls, articles, videos, and digestible summaries of clinical studies. Digital therapeutics help members manage stress, anxiety, and depression through self-directed programs tailored for all phases of the maternal journey. Coaching and telebehavioral health services support members with an extra touch of human care. 

Conversations icon-1FREE COMMUNITY AND EXPERT SUPPORT to deliver effective health needs screening approaches and identify high-risk pregnancy symptoms.

Twill's moderated care community helps seek answers and celebrate milestones with others who are expecting. Members utilize digital resources and educational content to manage common pregnancy symptoms, discuss areas of concern, and ask healthcare experts questions. 

Innovation-1EXECUTE ASSESSMENTS to better measure the baseline and improvement of members on their care journey.

Twill can configure and deploy needed assessments (health needs, SDOH, clinical, etc.), administer them digitally, and report/integrate with a plan’s needs.

Plus icon-1INTEGRATIVE FEATURES promote accessible, well-rounded patient care.

Seamless digital touchpoints to help direct, screen, and refer members to other health plan services such as in-network OB/GYNs, other clinical areas, and state/local resources.  Members can refer to in-network resources such as PCPs or pediatricians through 1-click calling.

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To learn more about what Twill has to offer your health plan in supporting Medicaid members, contact us today!

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Citations:

    1. Carrière, K., Khoury, B., Günak, M.M., & Knäuper, B.B (2017). Mindfulness-based interventions for weight loss: a systematic review and meta-analysis. Obesity Reviews, 19, 164-177.
    2. Schneider, J.K., Mercer, G.T., Herning, M., Smith, C.A., & Prysak, M.D. (2004). Promoting exercise behavior in older adults: using a cognitive behavioral intervention. Journal of Gerontological Nursing.
    3. Kalmbach, D. A., Cheng, P., O'Brien, L. M., Swanson, L. M., Sangha, R., Sen, S., ... & Drake, C. L. (2020). A randomized controlled trial of digital cognitive behavioral therapy for insomnia in pregnant women. Sleep medicine, 72, 82-92.
    4. Felder, J. N., Epel, E. S., Neuhaus, J., Krystal, A. D., & Prather, A. A. (2020). Efficacy of digital cognitive behavioral therapy for the treatment of insomnia symptoms among pregnant women: a randomized clinical trial. JAMA psychiatry, 77(5), 484-492.
    5. Bei, B., Pinnington, D. M., Quin, N., Shen, L., Blumfield, M., Wiley, J. F., ... & Manber, R. (2023). Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomized controlled trial from pregnancy to 2 years postpartum. Psychological medicine, 53(2), 513-523.
    6. Parks, A. C., Williams, A. L., Tugade, M. M., Hokes, K. E., Honomichl, R. D., & Zilca, R. D. (2018). Testing a scalable web and smartphone based intervention to improve depression, anxiety, and resilience: A randomized controlled trial. International Journal of Wellbeing, 8(2). https://www.internationaljournalofwellbeing.org/index.php/ijow/article/view/745 
    7. Shannon D. Simonovich, Nichole L. Nidey, Amelia R. Gavin, María Piñeros-Leaño, Wan-Jung Hsieh, Marissa D. Sbrilli, Lauren A. Ables-Torres, Hsiang Huang, Kelli Ryckman, and Karen M. Tabb. (2021) Meta-Analysis Of Antenatal Depression And Adverse Birth Outcomes In US Populations, 2010–20. Health Affairs. https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00801 
    8. Benatar, S., Cross-Barnet, C., Johnston, E., & Hill, I. (2020). Prenatal depression: assessment and outcomes among Medicaid participants. The Journal of Behavioral Health Services & Research, 47(3), 409-423.
    9. Coussons-Read, M. E. (2013). Effects of prenatal stress on pregnancy and human development: mechanisms and pathways. Obstetric medicine, 6(2), 52-57.
    10. Staneva, A., Bogossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women and birth, 28(3), 179-193.