Maternity Care Home Program

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Maternity Care Home Program: An Enhanced Prenatal Care Model

The Centers for Medicare and Medicaid Innovation awarded Signature Medical Group, Inc. a Strong Start for Mothers and Newborns grant in 2013. This launched Signature’s Maternity Care Home Program which provides patient-centric, physician-driven care addressing all aspects of women’s health including: physical, mental, and environmental aspects within a trauma-informed framework. An interdisciplinary care team provides care coordination between physicians, patients, and community partners to address the unique needs and stressors of each patient and reduce the likelihood of costly preterm births and adverse birth outcomes.

Our Call to Action

Our maternity care home program addresses unmet needs in perinatal care in Missouri. According to the March of Dimes premature report card, Missouri received a “C” for the average preterm birth rate. St. Louis City County received an “F”. The Bootheel of Missouri has one of the worst preterm birth rates in the country and with over 32,400 Medicaid births covered by Missouri in 2012 , reducing medical costs and improving patient outcomes is essential. Based on our preterm birth rate reductions, we estimate our program could save millions by expanding the program to Medicaid beneficiaries across Missouri.

1 March of Dimes 2014 Premature Birth Report Card 2 Markus, et al. Women’s Health Issues, 2013

 

Addressing Unmet Behavioral & Psychosocial Needs

Preterm births are a life-threatening and costly event. For pregnant women, behavioral health concerns including depression, stress, and anxiety, especially as related to social needs, can affect pregnancy outcomes.  Currently, most OB/GYN offices do not have the capacity to address the variety of social needs patients face that negatively affect pregnancy. Many women enter the program in a crisis state with emergency needs, experiencing stressors such as unmanaged medical and dental conditions, chronic unemployment, inadequate food supply, unsafe living conditions, domestic violence, substance abuse, and mental health concerns. All patients have access to nutritionists, childbirth education classes, smoking cessation, substance use counseling, family planning, and behavioral health services. In addition, our staff assist patients with the Medicaid application and approval processes by becoming Tier 1 certified.

Our Program – How we do it

Coordinated Care

An interdisciplinary team made up of an OB/GYN clinical team, nurse navigator, and social workers work together to address the patient’s medical, behavioral, and environmental needs. Social workers meet patients at their homes, in OB/GYN clinic offices, or telephonically. Biopsychosocial risk assessments, including universal screening for perinatal mood and anxiety disorders and interpersonal violence, identify factors that negatively impact maternal and fetal health. Addressing biopsychosocial needs through referrals to specialists and community partners is a key component of the program. The result is a promotion of healthy pregnancies, the reduction of factors associated with adverse outcomes including preterm births, and significant cost savings.