Findings from University of North Carolina Update Knowledge of Managed Care (The Association Between Care Management and Neonatal Outcomes; the Role of a Medicaid-managed Pregnancy Medical Home In North Carolina): Managed Care

2022 SEP 08 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting from Chapel Hill, North Carolina, by NewsRx journalists, research stated, “Preterm birth is a significant clinical and public health issue in the United States. Rates of preterm birth have remained unchanged, and racial disparities persist.”

The news correspondents obtained a quote from the research from the University of North Carolina, “Although a causal pathway has not yet been defined, it is likely that a multitude of clinical and social risk factors contribute to a pregnant person’s risk. State-based public health and provider programmatic partnerships have the potential to improve care during pregnancy and reduce complications, such as preterm birth. In North Carolina, a state-based Medicaid-managed Pregnancy Medical Home Program screens pregnant individuals for psychosocial and medical risk factors and utilizes community-based care management, to offer support to those at highest risk. This study aimed to examine the association between care-management and birth outcomes (low birthweight and preterm birth rates) among high-risk non-Hispanic White and Black pregnant people enrolled in the North Carolina Pregnancy Medical Home. This was a quasi-experimental study of people in the Medicaid-managed North Carolina Pregnancy Medical Home who had singleton pregnancies and who enrolled in the program between January 2016 and December 2017. Black and White pregnant people were included in the analysis if they had singleton pregnancies, were enrolled in the Pregnancy Medical Home, and for whom there were data regarding care management involvement. Preterm birth and low birthweight were chosen as the outcomes of interest. Two different methodologies were used to test the effect of care management on outcomes: Method 1 evaluated the effect of intensive care management (>= 5 face-to-face visits from a care manager) and Method 2 evaluated the effect of the implementation of a specific risk-stratification system. Chi-squared and multivariate logistic regressions were performed as appropriate. From January 1, 2016 to December 31, 2017, a total of 3564 singleton pregnancies occurred among non-Hispanic Black and White pregnant Medicaid beneficiaries, who were a part of the Pregnancy Medical Home in North Carolina. White pregnant people comprised 57% and Black pregnant people comprised 43% of the sample. In the Method 1 analysis, intensive care management was significantly associated with reductions in preterm birth and low birthweight among Black and White pregnant people whereas in the Method 2 analysis, the implementation of a risk-stratification score only resulted in a significant reduction among Black pregnant people. In multivariable logistic modeling, race, number of prenatal visits, and intensive care management were all significantly associated with the outcomes of interest. Care management is associated with reductions in preterm birth and low birthweight in the Medicaid-managed Pregnancy Medical Home in North Carolina. This study contributes to a growing body of literature on the role of state-based initiatives in reducing perinatal morbidity. These results are significant as it demonstrates the importance of care coordination and management, in identifying and providing resources for high-risk pregnant people.”

According to the news reporters, the research concluded: “In the United States, where pregnancy-related outcomes are poor, programs that address the multitude of economic, social, and clinical complexities are becoming increasingly crucial and necessary.”

This research has been peer-reviewed.

For more information on this research see: The Association Between Care Management and Neonatal Outcomes; the Role of a Medicaid-managed Pregnancy Medical Home In North Carolina. American Journal of Obstetrics and Gynecology, 2022;226(6). American Journal of Obstetrics and Gynecology can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; American Journal of Obstetrics and Gynecology - http://www.journals.elsevier.com/american-journal-of-obstetrics-and-gynecology/)

Our news journalists report that additional information may be obtained by contacting Divya Mallampati, University of North Carolina, Dept. of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Chapel Hill, NC 27515, United States. Additional authors for this research include M. Kathryn Menard and Carlos Jackson.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.ajog.2022.03.018. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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