JMIR Publications

ABSTRACT

Background:

Twitter is a potentially valuable tool for public health officials, particularly state Medicaid programs. Medicaid currently covers 72 million children, older adults, people with disabilities, and low-income populations, and is currently undergoing a variety of program and policy changes.

Objective:

We characterized how Medicaid agencies and managed care organization (MCO) health plans are using Twitter to communicate with the public.

Methods:

Using Twitter’s public API, we collected 160,380 public posts (“tweets”) from active Twitter profiles of state Medicaid agencies and MCOs, spanning March 2014-June 2019. Manual content analyses identified 5 broad categories of content, and these coded tweets were used to train supervised machine learning algorithms to classify all collected posts.

Results:

We identified 15 state Medicaid agencies and 81 Medicaid MCOs on Twitter. Mean number of followers was 1,784; mean number of those followed was 542; and mean number of posts was 2,476. Approximately 39% of tweets came from just 10 accounts. Of all posts, 39.8% were classified as general public health education and outreach; 23.5% were about specific Medicaid policies, programs, services, or events; 18.4% were organizational promotion of staff and activities; and 11.6% contained general news and news links. Only 4.5% of posts were responses to specific questions, concerns, or complaints from the public.

Conclusions:

Twitter has the potential to enhance community building, enrollee engagement, and public health outreach, but appears to be underutilized in the Medicaid program.