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Health Team

Prenatal care program yields Medicaid savings, healthier babies

Posted April 23, 2012

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— A prenatal care program is saving Medicaid money and helping healthier babies be born, state health officials believe.

The Pregnancy Medical Home program is aimed at preventing complications for mother and baby and reducing preterm births, thereby saving the state money.

"Every 1 percent of reduction (of preterm births) is $50 million in savings for the state, while you're having better health outcomes in doing it," said Al Delia, acting secretary of the North Carolina Department of Health and Human Services.

Prenatal program saves lives, money Prenatal program saves lives, money

Fifty-six percent of babies in North Carolina are born to mothers enrolled in Medicaid, and 11 percent of those babies are of low birth weight, usually due to preterm birth.

It costs the state Medicaid program about $3,000 to care for a full-term baby in the first year of its life. For babies born early, that cost jumps up to $74,000 – 25 times higher.

As a Medicaid patient, Karima Elqira was assigned to the Pregnancy Medical Home program when she was diagnosed with gestational diabetes. She got the help of a pregnancy care manager for her high-risk pregnancy.

"Even when I (did) not come to appointments, she call me and ask about me," Elqira said. "She's just like, you know, my best friend. That's what I feel."

Private primary car providers enrolled in the program get financial incentives for cost-saving practices. Those include performing an initial risk screening, eliminating elective deliveries, providing postpartum care, encouraging vaginal deliveries and giving at-risk patients a 17P injection, a hormone shot that decreases the risk of preterm labor.

Obstetrician-gynecologist Cathy Weaverly-Jones, with the Wake County health department, said the first year of the program has proven its worth in both cost savings and healthier moms and babies.

"I came here, you know, and they fix everything," Elqira said.

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  • righthere1234 May 1, 2012

    Babbleon, I had no problems going back to work and breastfeeding my 2 children for over a year, pumping included. Pumping was not painful at all, and my $250 pump that I used for 2 babies was A LOT cheaper than formula.

    Freedomrings, I've known several moms on WIC in different parts of the country, and many WIC offices are started to really focus on breastfeeding instead of formula, including helping with a pump.

    Overall my issue with this article is the high rate of women on Medicaid while pregnant. My husband and I were barely above the poverty line when I was pregnant with our first child. I was laid off 6 months into my pregnancy and we still managed to rely on my husband's insurance for my prenatal care (high risk) and for the resulting c-section.

  • babbleon Apr 30, 2012

    What I have a REALLY big problem with is WIC paying for loads of infant formula. freedomrings

    While most women can breastfeed, it ties them to the child, or to a $200ish breastpump (which is actually painful after a few weeks - it sucks harder than a kid - been there). Infant formula is not as good as breast milk, but it lets moms go back to work sooner.

    As a country, it would be nice if we could make up our minds. Do we want moms to have optimally healthy babies and be able to work (requires cheap pumps & privacy, cheap decent child care, or extending maternity leave, with job guaranteed to still be there) or do we want them to stay home (requires higher minimum wage, better jobs available for dads) or do we want them to not have kids until they can pay for everything themselves (requires better education, easy access to birth control, cheaper medical care / insurance, higher minimum wage)?

    It's like we want results for no work.

  • ItIsWhatItIs2 Apr 27, 2012

    . I wish I didnt have to pay anything to have my baby, but oh wait, I went to college, got a degree, found a job, work hard and pay for health insurance biweekly....

    In my defense to this comment. .. I went to college, paid for college on my own, work full time, have worked full time for consistantly since I have been out of college, I have a great job that I have been at for 18 years, and I have health insurance that is terrible.. I am currently pregnant, with a very high risk pregnancy b/c I had my son at 24 weeks, and he spent 100 days in the NICU.. with that being said, I got pregnancy medicaid, not b/c I sit on my behind daily and dont work and want "tax payers" which I am one of those to pay for it, but b/c being high risk the care that I need is intense. My insurance would not cover nearly enough that I would have been able to make it without some help, so my Dr....and educated person, with a degree and a job encouraged me to apply for the medicaid b/c in her eyes, it should b

  • freedomrings Apr 26, 2012

    pirate09 : I agree with you on circumcision 100%.

    However, your comment about people on Medicaid is pretty judgmental. It truly is. My husband has a bachelors degree, works about 50-55 hours a week, and is also is currently attending school to even further his education. We found ourselves with a surprise pregnancy, our first and last. His insurance through his company would have been over $1000.00 a month. We had to go on pre-natal medicaid. We chose a free-standing birthing center so we could cost the state less because hospital births are extremely high. Ironically, the Medicaid office also pushed WIC, which we declined.

    Thankfully, after our son was born, we found a decent catastrophic plan that we can afford with me working on the weekends.

  • freedomrings Apr 26, 2012

    I didn't realize the number was so high. Pretty surprising.

    What I have a REALLY big problem with is WIC paying for loads of infant formula. With proper support 95 % of of women can breastfeed, so why all the formula? It's been scientifically proven that formula babies have a much higher rate of allergies, asthma, ear infections, diabetes...the list goes on and on. It seems to me, if the government REALLY wants to curtail over spending, not covering formula unless it's absolutely necessary would be helpful.

  • kikinc Apr 26, 2012

    My point was the issue of entitlement that people have. They feel everything should be free. I have no problem with people using Medicaid the way it was meant to be used. I have a problem with those who abuse it.

  • carolinagal78 Apr 26, 2012

    Regardless, it doesnt matter about the circumcision. The delivery is a majority of the cost. I don't think we are concerned about the "accidental" medicaid birth as much as the people who are having more than one child and remain on medicaid. Something needs to be done. I shouldn't have to pay for it.

  • kikinc Apr 26, 2012

    My comment was tongue in cheek. Sorry you missed that point.

  • pirate09 Apr 25, 2012

    get Medicaid. She was all excited when she found out there was no copay, but then was perturbed b/c the hospital told her she had to pay for the circumcision.
    kikinc

    Circumcision is not a NECESSARY medical procedure. So no my tax dollars should not go to someone to pay for them to have a procedure that is now considered cosmetic and not medically necessary. I wish I didnt have to pay anything to have my baby, but oh wait, I went to college, got a degree, found a job, work hard and pay for health insurance biweekly....

  • kikinc Apr 24, 2012

    56% of babies are born to mothers with Medicaid?!?! That's ridiculous. I have health insurance, a steady job, and affording a child will be rough on me. Wish I could pop one out for free, too.

    To be fair, though, some women are on Medicaid b/c they have an accidental pregnancy, and realize that they have no maternity coverage on their insurance. Happened to a friend of mine. Someone told her to get Medicaid. She was all excited when she found out there was no copay, but then was perturbed b/c the hospital told her she had to pay for the circumcision.

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