Medicaid prenatal care nets good birth outcomes
If your center takes care of Medicaid patients, you could be getting a little extra help at no extra cost. Forty-four states offer an enhanced prenatal package. The states not offering the package are Arizona, Florida, Maine, North Dakota, Texas, and Wyoming. The enhanced prenatal package includes some or all of the following: case management, risk assessment, nutritional counseling, health education, psychosocial counseling, home visit(s), and transportation.
To find out what enhanced prenatal services your state offers to Medicaid clients, contact your city or county public health department.
In Colorado, the enhanced package, Prenatal Plus, dovetails with private practices that often lack the extra resources to address high-risk Medicaid pregnancies. Maggie Gier, RNC, MS, associate director of nursing at Tri-County Health Department in Englewood, explains how it works.
All physicians’ offices and women’s health facilities that serve Medicaid patients receive visits from health department nurses. The nurses introduce Prenatal Plus and encourage practitioners to enroll their patients.
Women who enroll meet a Tri-County maternal health nurse at the medical office or at a health department facility for counseling on diet, cigarettes, alcohol, and drug use. Each patient receives two home visits during the pregnancy.
"Most of the doctors tell us that the women who participate in Prenatal Plus are better at keeping appointments, and they lower their prenatal risks by reducing their smoking and substance abuse," Gier notes.
Gier’s statement is verified by figures released by the women’s health section of the Denver-based Colorado Department of Public Health and Environment’s family and community health services division in 1996. Among the 844 enrollees, 708 stayed with the program. Forty-one percent of the smokers quit, and 88% of the drug and alcohol users abstained. Without the Prenatal Plus intervention, according to the women’s health section data, low-birth-weight rates would have been 11.9%, compared to the actual 8.9%.
"This program proves there’s still a role for the community health department in supporting private providers in what they do so well," says Gier.
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