What Happens to NC Babies Without Health Insurance?

>>BY SARA LANG

When I was pregnant, I hated the frequent appointments with my obstetrician. I wanted to just focus on the healthy development of my baby, but instead I was waiting around in a doctor’s office, worrying over endless numbers of tests.

For too many North Carolina women, the prenatal appointments I dreaded are a luxury. Whether due to the delayed arrival of a Medicaid card, difficulty getting time off work, or simply problems finding a doctor, many North Carolina mothers-to-be have trouble accessing the care they need.

Those barriers to care have serious implications for the health of North Carolina mothers and babies. The risks are especially high for poor and minority women and for those in urban centers. In 2012 (the most recent year for which data is available), one third of pregnant Medicaid patients did not receive first trimester prenatal care. Wait times for a new obstetrician appointment can exceed 60 to 90 days.

>>Pregnancy Medical Home (PMH) is a program spearheaded by Community Care of North Carolina (CCNC) in partnership with the Division of Medical Assistance (DMA) and other community stakeholders. Its goal is to provide pregnant women on Medicaid with better care overall and improve the health of NC babies.

CCNC’s >>14 local networks each have an obstetrician team with one or more >>physician champions and at least one >>nurse coordinator, who is the primary point of contact for the PMH program in each local CCNC network.

Prenatal care providers join the program and receive support from CCNC, including assistance from the local network, clinical guidance and training, specialized data, and ongoing collaboration with a pregnancy care manager. By participating in the program, the providers are also can earn financial incentives from Medicaid.

In turn, practices agree to work toward improving health measurements, such as eliminating elective deliveries before 39 weeks, reducing primary c-section rates, improving the postpartum visit rate, and more.

Doctors across the state have embraced the program and many are now accepting more Medicaid patients. There are currently 380 practices and 1,650 individual providers (OB/GYN, family medicine, midwifery, physician assistants, nurse practitioners) participating in NC — and representing more than 85% of maternity providers in the state.

Care managers coordinate women’s care across doctors and connect them to community resources like childbirth or breastfeeding education classes, family planning, and the WIC nutrition program. They answer questions, schedule follow-up appointments, and provide education about infant care.

Growing a child is enough work for any mom. We should applaud our North Carolina health care providers and leaders who are making it a little easier for women to receive the quality care they need to be healthy – and to raise healthy babies.

>>Sara Lang has worked in North Carolina politics at the state, federal, and local levels for more than 15 years. A communications consultant, she lives in Cary with her husband, two young children, and a pampered dog.