The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61056

Janet Catov, MS and Pat Boody, RN. Preventive Health and Disease Management, Gateway Health Plan, Two Chatham Center, Suite 500, Pittsburgh, PA 15219, 412 255 4343, jcatov@gatewayhealthplan.com

BACKGROUND: Over one third of all children in the US are covered by Medicaid, and 56% of all Medicaid beneficiaries are enrolled in Medicaid managed care plans. In Pennsylvania, Medicaid covers 24% of all births. Identifying opportunities to improve birth outcomes to women covered by Medicaid is of critical public health importance. OBJECTIVES: To improve rates of prenatal care visits, and reduce rates of prematurity and low birth weight through maternity care coordination and education provided by a Medicaid managed care plan. METHODS: Gateway Health Plan is one of the ten largest Medicaid managed care organizations in the country. The MOM Matters Program was implemented in 1998 to promote early prenatal care, provide education and support to all pregnant members, and provide telephonic care coordination, smoking cessation, and home nursing to high risk women. RESULTS: In 2001 14.2% of pregnant members had a history of preterm labor or delivery. 35.2% were current smokers, and 3.1% reported current drug or alcohol dependence. Prenatal care within the first trimester increased significantly from 76.1% in 2000 to 80.7% in 2001 (p-value<.0001). Prematurity rate for 2001 was 10.7%, below the national average of 11.5%. There has been little change in rates of low birth weight from 1999 to 2001. However, rates for moderate prematurity demonstrated subtle but important differences between those enrolled in the high risk program compared to plan wide deliveries. CONCLUSION: It appears that maternity care coordination, home nursing visits, coordination with OB providers, plan wide prenatal education and a multi-year emphasis on improving maternal health has led to improvements in important health outcomes in a Medicaid managed care plan.

Learning Objectives:

• At the conclusion of the session, the participant will be able to identify the key components of a maternity care coordination program, understand how to monitor the impact of these program components, and identify opportunities to improve maternal and child health in a Medicaid managed care environment.

Keywords: Pregnancy Outcomes, Medicaid Managed Care

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment