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CCNC's program for pregnant Medicaid patients reduces rate of low birth weight babies, helps lower healthcare costs

CCNC's program for pregnant Medicaid patients reduces rate of low birth weight babies, helps lower healthcare costs

CCNC's Program for Pregnant Medicaid Patients Reduces Rate of Low Birth Weight Babies, Helps Lower Healthcare Costs

RALEIGH, N.C. -- March 27, 2015 -- North Carolina has struggled for a decade with increasing rates of low birth weights, but new data shows a promising reversal in the state’s Medicaid population. Since a statewide program launched, babies born weighing less than 5.5 pounds have decreased from 11.06% of all births to 10.53%. The improvement is significant because medical costs for low birth weight babies can be very high. Medicaid plays a critical role in North Carolina, financing 55 percent of all births in the state.

Community Care of North Carolina (CCNC), the physician-led nonprofit that helps manage the utilization of the state’s Medicaid program, first launched the Pregnancy Medical Home (PMH) program in 2011. Statewide, 390 practices participate in the PMH program, representing 90 percent of the care delivered to pregnant Medicaid beneficiaries. Obstetricians attribute improved birth weight gains in newborns as a positive outcome of the well visits by care managers in the program.

“CCNC's network of physicians and nurses across the state allows us to effectively connect with the providers and patients who need our assistance the most,” said Kate Berrien, RN, BSN, MS, Pregnancy Medical Home Project Manager for CCNC. “Eighty percent of pregnant Medicaid patients identified as being at risk for poor birth outcomes are contacted by a pregnancy care manager within 30 days of the initial identification.”

On a percentage basis, even small improvements in infant birth weight rates can impact Medicaid budgets. The medical costs for low birth weight babies average $49,000 in a baby’s first year of life, or more than ten times more than babies born without complications. A low birth weight also increases a child’s risk for long-term medical and developmental complications and the likelihood of incurring additional expenses for social services and educational needs in later years. The rate of primary cesarean delivery (women having their first C-section) has also steadily decreased, which helps to reduce the rate of future cesarean deliveries. This represents a substantial costs savings in hospital costs for delivery.

CCNC has disseminated and implemented a series of evidence-based, cost-effective clinical standards across all PMH practices in North Carolina. These best practice standards address: management of hypertensive disorders of pregnancy, induction of labor, use of progesterone for preterm birth prevention, perinatal tobacco use, postpartum care and management of substance use in pregnancy.

“Last year, North Carolina had the lowest rate of elective deliveries before 39 weeks among all southern and southeastern states. The Pregnancy Medical Home program is playing a major role in improving health outcomes of mothers and their babies,” said Berrien.

About Community Care of North Carolina

CCNC is a community-based, public-private partnership that takes a population management approach to improving health care and containing costs for North Carolina’s most vulnerable populations. CCNC creates “medical homes” in all 100 counties for Medicaid beneficiaries, individuals that are eligible for both Medicare and Medicaid, privately-insured employees and uninsured people. To learn how CCNC saves North Carolina millions of dollars every year, visit www.ccnccares.com. For more information, visit our website, www.communitycarenc.org.

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