To coincide with the March of Dimes Prematurity Awareness Month, The Center for Best Practices has selected Centene Corporation's Start Smart for Your Baby for November’s Keeping You Healthy video. Start Smart for Your Baby was also a nominee of the 2011 MHPA Center for Best Practices Children's Health Award, Make a Difference Award and the Innovation Award.
For more information on Centene, please visit http://www.centene.com.
Start Smart for Your Baby® 17P Program Impact on Reducing Premature Birth
DESCRIPTION: The Start Smart for Your Baby® 17P Program identifies women who qualify for 17 alphahydroxyprogesterone caproate (17P) injections. 17P is a naturally occurring metabolite of the hormone progesterone, and is endorsed by the American College of Obstetricians and Gynecologists for use during certain high-risk pregnancies to reduce the rate of recurrent preterm delivery and neonatal intensive care (NICU) admissions.
Members are identified as potential candidates for 17P based on a Notification of Pregnancy form completed by the member, OB staff or physician, case manager in collaboration with vendors or claims history showing a prior preterm delivery.
ACTION TAKEN: An early identification process was established using a variety of data sources, along with an educational program aimed at physicians, their office staff and plan members in order to increase 17P utilization in appropriate candidates. Once the candidate meets the qualifications for the program and the physician prescribes 17P, arrangements are made to administer the injections either in the physician office or through home health by the case management team. Case management also includes: weekly or biweekly member contact, communication with the OB, educational materials, locating providers for home health or DME, referrals for transportation and post-partum welcome home assessments.
OUTCOME: A 2009 review was conducted of birth outcomes of 596 members treated with 17P versus a control group of 60 women not treated with 17P. Deliveries with a gestational age of less than 37 weeks decreased from 51.7% in the control group to 39.9% in the 17P group when 17P was initiated by 28 weeks gestation. Low birth weight deliveries (defined as birth weight less than 2500 grams) decreased significantly from 48.3% in the control group to 33.3% in the 17P group. And NICU or special care nursery admission rates decreased significantly from 45.0% in the control group to 29.2% in the 17P group.
Offering 17P as a benefit has a positive effect on reducing the rate of recurrent preterm delivery and rate of NICU and special care nursery admission in a managed Medicaid population.
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CONTACT:
Mary Mason, MD
Senior Vice President and Chief Medical Officer, Centene Corporation
(314) 725-4477; mmason@centene.com
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