| Guest columnist
The Clarion Ledger: Local journalists telling Mississippi stories
The Clarion Ledger is local journalists telling local stories. Connect with your community by subscribing today.
Barbara Gauntt, Clarion-Ledger
The premature birth rate in Mississippi increased from 13.6% to 14.6% from 2017 to 2019, according to the Mississippi State Department of Health. That 1% increase seems small, but total medical costs associated with premature births are huge and harmful to Mississippi taxpayers, who cover 70% of births.
According to MSDH hospital data, in 2018 Medicaid covered the medical costs of 2,142 premature babies born between 27 and 37 weeks. The greatest costs are associated with babies born before 32 weeks, but medical expenditures for late preterm babies are also quite high.
Nearly 16% of the premature births occurred at 34 weeks, at an average cost of $12,678 for each baby, $13,878 for the mother, and $110,039 for medical complications during the first year of life, totaling $136,595. In contrast, the average birth cost — $5,847 — for a full-term baby was substantially lower and $9,601 for the mother.
Medicaid members who are 19 years of age and older are assigned to one of the three coordinated care organizations (CCO) that are tasked with reducing premature birth rates and related costs. However, these organizations continue to perform poorly in this area.
For instance, during the first six months of 2019, members within the network of one CCO plan experienced a premature birth rate of 17.1%, 4% higher than the state average, which is the highest in the nation. As of July 1, 2019, the company had incurred an average cost of $49,402,96 per preterm baby, totaling $15,463,126 for 313 babies.
Mississippi Medicaid Medical Care Advisory Committee concluded that preventing 5% of premature births would save $885,883.50 to this plan and an estimated $2.7 million savings to the state of Mississippi.
The Committee identified obesity as one of the leading factors associated with premature births in Mississippi. Obese pregnant women are more likely to develop hypertension, diabetes and heart disease. Also, 70% of mothers who delivered a preterm baby was diagnosed with hypertension, which is strongly associated with preeclampsia.
From 2016 – 2017 and 2019 – 2020, Sisters in Birth in Jackson has assisted 68 Mississippi women and teens with delivering a healthy baby. Most of our clients were overweight or obese when they became pregnant but were not aware of the adverse effects. Our intervention assisted them with attaining with a healthy prenatal weight through modest lifestyle changes.
We also screened for and coached against tobacco, alcohol and illicit drug use, advocated for timely and appropriate obstetrical and allied health care, improved communication between them and their physicians and ensured they attended all prenatal and postpartum appointments, and we provided continuous labor and psychosocial support.
Eighty-two percent of our clients’ births were covered by one of the three coordinated care plans: Mississippi Magnolia, 35%, United Health Care, 29%, and Molina, 13%. Blue Cross Blue Shield of Mississippi members accounted for 18%. Our clients’ average medical induction and vaginal birth rates were 25% and 77%, respectively.
All medical inductions and C-sections were medically necessary, including Lupus, breech births, nuchal cords, Fetal bradycardia, two hypertensive patients, and two diabetic patients. Approximately 90% of clients delivered a full-term baby, averaging 39 weeks. Also, 80% of them initiated breastfeeding within the hospital. Subsequently, we have saved tens of millions in medical costs to the health plans and the state of Mississippi.
If the CCOs would partner with us, hence share the costs associated with delivering our services, we could serve significantly more residents at risk. CCOs such as Amerigroup of DC and Amerihealth Caritas of DC have successfully partnered with comparable community health organizations to address the numerous issues that negatively impact the Medicaid population’s birth outcomes. These organizations have experienced substantial medical cost savings while reducing premature births and infant and maternal mortality rates.
This year, the Mississippi Division of Medicaid will consider new proposals from various coordinated care organizations to serve the Medicaid population. It would behoove the Medicaid administration to reward contracts to companies that are willing to invest in our preventive-based services.
Getty Israel of Jackson is CEO/president of Sisters in Birth.