Pregnancy Medical Home

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, Access East provides 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, the PMH is primarily focused on preterm-birth prevention.

The PMH program was created in collaboration with the N.C. Division of Health Benefits (DHB) 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 North Carolina’s maternity-care providers – more than 350 practices and some 1,600 individual providers.

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 an Access East care-manager
    • 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