Pregnancy Medical Home
An estimated one in 10 babies is born too early in the United States, with the U.S. preterm birth rate higher than that of most other high-income countries.
The problem is much bigger even than ballooning healthcare costs from long-term hospitalizations required to care for these fragile newborns; premature births account for many child deaths, making up a large part of the infant-mortality rate.
Yet in much of the U.S., there are too few obstetrics (OB) practices/providers willing to supply care to Medicaid recipients, typically some of the most medically vulnerable members of the population.
To address this disparity, and to tackle other issues in maternity care and birth outcomes among Medicaid-eligible women, our state partners at Community Care of North Carolina (CCNC) have tasked member networks with providing care-management services to pregnant Medicaid recipients through what’s known as a Pregnancy Medical Home (PMH). Built around the medical home model of patient-centered, consolidated, cost-effective care that’s central to CCNC, the PMH is primarily focused on preterm-birth prevention.
Administered through CCNC’s 14 member networks, the PMH program was created in 2011 in collaboration with the N.C. Division of Medical Assistance (DMA) and other community stakeholders, including Medicaid providers, local health departments, and the state Division of Public Health (DPH). The program now includes the majority of our state’s maternity-care providers – more than 350 practices and some 1,600 individual providers.
Each CCNC network, including Community Care Plan of Eastern Carolina (CCPEC), has a team to recruit and support local OB providers to increase access to care and improve health outcomes for our Medicaid population.
Benefits to Participating Practices
Providers participating in the PMH program receive:
- Financial incentives from Medicaid for risk-screening and postpartum-visit completion
- Ongoing collaboration with a CCNC-network pregnancy care-manager
- Local CCNC support, in this case from regional network affiliate CCPEC
- Data and analytics from CCNC’s Informatics Center (IC)
- Clinical guidance materials and resources
In turn, practices agree to work toward a set of quality-improvement goals, a small sample of which includes:
- Reducing the rate of primary Cesarean-section deliveries
- Eliminating elective deliveries prior to 39 weeks of gestation
- Improving the postpartum-visit rate
- Using Compounded Hydroprogesterone Caproate (17p) to prevent recurrent preterm births
PMH Resources for Practices
Clinical guidance on the management of specific medical conditions related to pregnancy can be accessed through the CCN PMH Care Pathways page, here.
PMH risk-screening forms, last revised September 2013, are available through these links:
For More Information
Contact Missy Burrell, BSN, RN, CCPEC Pregnancy Medical Home OB Coordinator, at (252) 847-5031, or email@example.com.