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Poster Session 4

Category: Hypertension

Poster Session 4

(1119) Comparing engagement among postpartum individuals with public versus private insurance in remote hypertension monitoring program.

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Jennifer Okunbor, MD (she/her/hers)

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States

Coauthor(s)

Mary Marchese, MD

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
AM

Allison K. Mak, MD

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
RM

Rose C. Mahoney, MD

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
SM

Scott Machado, MPH

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
TJ

Tracy L. Jackson, PhD

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
NK

Nicole Konecke

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
WH

William Hunt

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
DS

Danielle Simmons, FNP

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
MM

Maria Mejia Castillo, CHW

Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
MT

Methodius G. Tuuli, MBA, MD, MPH

Chace-Joukowsky Professor of Obstetrics and Gynecology, Chair of Obstetrics and Gynecology
Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, and Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States
Adam K. Lewkowitz, MD, MPHS

Assistant Professor
Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
AH

Alisse Hauspurg, MD, MS

Brown University
Providence, Rhode Island, United States

Objective:
Engagement in remote self-measured blood pressure (SMBP) monitoring programs reduce rates of hypertension (HTN)-related hospital readmission, emergency department (ED) visits and severe maternal morbidity (SMM). Our aim is to examine whether insurance type is associated with differences in engagement and outcomes among SMBP program participants.

Study Design:
Patients with hypertensive disorders of pregnancy (HDP) are provided BP cuffs and remote clinical support from a bilingual community health worker (CHW) and nurse practitioner for 6 weeks after delivery. For this analysis, participants were stratified by insurance type at enrollment: public (Medicare/Medicaid) vs private insurance. The primary outcome was engagement in the program, defined as submission of ≥1 BP within 10 days of discharge per ACOG guidelines. Secondary outcomes included total number of BP reported, a composite of HTN-related readmission or ED presentation, frequency of SMM, and remote anti-hypertensive medication initiation. A generalized linear model estimated relative risks (RR) after adjustment for confounding factors.

Results:
Among 2623 participants enrolled in the SMBP program, 44.7% were publicly insured. Compared to those with private insurance, publicly insured participants were younger, less likely to identify as White, more likely to have chronic hypertension with superimposed preeclampsia. After adjusting for these differences, engagement in the SMBP program was significantly lower in the publicly insured group compared to the privately insured group [(37.4% versus 55.8%; aRR 0.78 (0.71, 0.85)]. Publicly insured patients sent on average 4 fewer blood pressures compared to privately insured patients [11.8 (12.6) vs 19.1 (16.7); adjusted β -4.31 (-6.08, -2.53)]. There were no differences in hypertension-related ED visits, readmissions, or SMM between groups.

Conclusion:

Engagement with the SMBP program was lower among publicly insured patients compared to privately insured patients. Our findings suggest the need to explore interventions in publicly insured postpartum people to support participation in these programs.