When looking to reduce long-term healthcare costs, health plans usually look to the chronically ill and implement programs in hopes of improving outcomes. Health plans should additionally look to a much younger set—infants and their mothers.
The cost of preterm births was at least $26.2 billion, or $51,600 for each preterm infant in 2005. The length of stay for premature children is 13 days, compared to 1.5 days for a term infant. In a preterm child's first year alone, the average medical cost, including inpatient and outpatient care was about 10 times greater than for term infants, according to the March of Dimes.
But health plans should not just analyze the first year of a preterm infant's life. Preterm babies can suffer long-time (sometimes lifelong) health issues.
With this information in mind, health plans are beginning to implement programs geared to help women with high-risk pregnancies. Matria Healthcare has an outpatient management program for women with preterm labor, and a study found the program saved money through fewer ER visits, averted antenatal hospitalizations for the mother, and fewer neonatal ICU admissions for the newborn.
The Marietta, GA-based health plan found a 3:1 ROI when comparing the outpatient program to a control group. Overall, the study researchers reported Matria saved $12,597 per pregnancy during the study period.
"The ROI is one piece of it, but with these types of pregnancies, it's the impact of not just the cost of hospitalization of the mom and the immediate costs for hospitalization of the baby in a NICU, but there is also the long-term and disability costs that have to be borne by our healthcare system," says Gary Stanziano, MD, senior vice president at Matria. There are many reasons that a woman could have a high-risk pregnancy. One that might not come to mind immediately is alcohol or drug use. Kaiser Permanente's Early Start program is an obstetric clinic-based prenatal substance abuse treatment program that tests all expectant mothers for drug use and connects those in danger to a licensed substance abuse expert in the OB/GYN department of its 40 outpatient obstetric clinics.
A study recently published online on the Journal of Perinatology found that the Early Start program improved outcomes for expectant mothers using alcohol or drugs. The expectant mothers with substance abuse issues who were not enrolled in the program had significantly worse outcomes, including preterm delivery and placental abruption.
In addition to the licensed substance abuse expert, called the Early Start specialist, the program includes universal screening of all women for drugs and alcohol by questionnaire, and by urine toxicology testing (with signed consent). And the program educates providers and patients about the effects of drugs, alcohol, and cigarette use in pregnancy.
Nancy C. Goler, MD, regional medical director of the Early Start program for Northern California at Kaiser Permanente Medical Group, in Vallejo, CA, says a key to the program is universal testing, which removes any prejudices. She says testing for drug use should be as routine as treating diabetes.
"[Testing] needs to be universal, and as non-judgmental and non-punitive as possible," says Goler, who was also a co-author of the study.
ROI wasn't part of the study, but the researchers wrote that an internal business care cost analysis for Early Start resulted in a 30% cost savings.
These ROI numbers alone should serve as a wakeup call to health plans without high-risk pregnancy programs. But be forewarned: a high-risk pregnancy program might not see savings immediately.
Instead, expect to invest money in the front end with the understanding that longer pregnancies, and averted hospitalizations and ER visits, will save money in the long run.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com .
Note: You can sign up to receive Health Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
Lost for ideas on where to target your audience? With gas prices and public transportation numbers at a high, why not look to transit advertising? Bayshore Community Health Services in Holmdel, NJ, is one facility that has recently decided to launch a transit-based strategy that has resulted in increased community awareness and local train station domination.
Bayshore launched initial research to determine where to target their consumers. "A lot of people who have moved to this area relocated from New York City,' say Bob Gagauf, president of Bayshore's agency, R&J Group in Parsippany, NJ. "We're in a booming real estate market in an area that is attracting more, well-off, sophisticated, well educated people. Being only 45–50 minutes from New York City, a good segment of that target market is going to be going through the train station.'
Focusing on a need to increase brand awareness, with a train station only a stone's throw away from the hospital, Bayshore jumped on the opportunity to target their audience in a new way. They used one-, two-, and three-sheet posters at various stations along the transit line along with light pole banners.
"If you went to the station all you saw were ads for Bayshore,' says Gagauf of the ‘train station domination' strategy. Bayshore also put up displays and deployed staff to interact with commuters, answer questions, and give out pamphlets.
The ads positioned Bayshore as a community facility with an interest in asking its consumers important questions about their adult lives with simple corresponding imagery. One example can be seen in the poster featuring an apple with copy that asks, "What's Next?' It goes on to discuss that health is a priority and that the professionals at Bayshore know where ‘you're' coming from. It finishes with, "Yes, welcome to time-crunched, fast-paced, wonderful adulthood—and care designed just for you,' with a call for action to the Web site neatly tying it all together.
An added bonus to the transit advertising is the length of exposure. With transit the average wait time for a train is about 5 minutes according to Gagauf. "That's more time than they would spend with a billboard,' says Bob Szalva, media director for R&J Group. "Most people are there every day, seeing the messages at all the stations.'
Overall, research showed that the outdoor advertising had the single largest increase in awareness for the facility. "There was a significant increase in awareness and in terms of effectiveness it was cost effective too,' says Gagauf.
Kandace McLaughlin is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kmclaughlin@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
Hundreds of volunteer medical professionals in Virginia are preparing to break records again with the ninth annual Rural Area Medical Clinic from July 25 to 27. The clinic will provide a wide range of free medical care to those in need. The 2007 clinic set national records with 2,506 patients receiving 8,401 procedures, according to a news release from the University of Virginia Health System. Clinic organizers expect to break those records in 2008.
The American Academy of Family Physicians has created an online community for family physicians in rural areas. The Rural Online Community features links to headlines from national and local publications on topics of interest to rural FPs, an e-mail discussion list for community members, an online library community members can use to post resources to share with others, rural FP profiles, updates on pertinent legislative issues, a calendar of events for rural FPs across the country, and rural health resources on topics including reimbursement, coding, practice management and AAFP policies.
To help increase the number of physicians practicing in rural Arizona, every summer a select group of physicians in rural communities throughout the state has mentored medical students from the University of Arizona College of Medicine. The physicians volunteer as preceptors, or mentors, to UA medical students between the first and second years of medical school. The students work at the physicians' practice sites and reside in their communities. The physicians are rural faculty members in the UA College of Medicine's Rural Health Professions Program, established by the Arizona Legislature to encourage medical school graduates to practice medicine in rural communities.
Under a new program of the Colorado Health Foundation, doctors will get help paying off their medical-school student loans in exchange for agreeing to practice in rural communities. Fifty-seven of Colorado's 64 counties lack enough primary-care physicians to serve local people, state officials say. That's partly because young doctors need the higher salaries and fees available in big cities to pay off student-loans. The new "Physician Loan Repayment Program" is aimed to tackle the problem, officials say.