Early prenatal care is a means to a healthy baby. The Healthy People 2000 Goal aimed for 90% of all pregnant women to receive prenatal care in their first trimester. As of 1995/1996, around 80% of expectant mothers in the US met this goal. These two benchmarks provided a means to appraise how well expectant mothers in a primary care case management (PCCM) model in Texas' Southeast Region did relative to this goal as well as to US expectant mothers in 1995/96. In all instances, no county in this Region was able to reach that 2000 goal, though Harden (89%) and Orange County (89.4%), for all practical purposes, did. Chambers, Jefferson, and Liberty Counties fell far short of the 2000 Goal. Delay in prenatal care can lead to a low birth weight (LBW) and/or premature baby. The 2000 Goal calls for a LBW rate of only 5.0%. In 1995/96, that rate was 7.3% nationwide. Chambers County, the county with the highest percentage of mothers with inadequate prenatal care, had the highest proportion of LBW babies (8.5%); Jefferson County was close behind (8.2%). Harden (6.8%), Liberty (6.8%), and Orange (6.2%) Counties, though below the national 1995/96 rate, remained above the 2000 goal. During SFY 1999, a significantly higher proportion (p<.05) of complex newborns were born in this Southeast Region. This proportion was far higher in every quarter, but the first, than in any other reported Medicaid managed care service area in Texas. That translates into critical use of expensive hospital resources.
Learning Objectives: At the end of the presentation, attendees will:
1. Understand the reasons for late or no prenatal care in the Southeast Region Medicaid Managed Care Waiver area.
2. Understand the impact of late or no prenatal care on birth weight and delivery of a complex newborn.
3. Appreciate the fact that a major goal of the move to Medicaid managed care, the creation of a medical home for the member, was not realized for prenatal care patients under the PCCM model in Southeast Texas.
Keywords: Medicaid Managed Care, Maternal and Child Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Public Policy Research Institute (PPRI) at Texas A&M U.
State of TX Access Reform (STAR) in the SE region of Texas
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 129th Annual Meeting of APHA