Improved Birth Outcomes Through Health Plan and Community Hub Partnerships [18L

Abstract

INTRODUCTION: An analysis to determine if Medicaid health plan clinical program activity combined with community based care coordination (community hubs) can improve birth outcomes by reducing non-clinical/social determinant barriers to care. METHODS: We conducted a retrospective cohort study of 3702 deliveries in Lucas County, Ohio. All deliveries in these areas between March 2013-February 2017 were included. Outcomes were derived from medical claims. Levels of community-based social services were obtained from our community hub partner. We used bivariate and multivariate analysis to identify Odds Ratios for Neonatal/NICU Admission by select predictors for all deliveries and separately for deliveries to high-risk, moderate-risk, low-risk, and unknown risk mothers in the service area. RESULTS: High-risk mothers in these service areas where the member was not exposed to any community hub activity were 1.55 times more likely to deliver a baby needing Special Care Nursery or NICU care when compared to high risk members who received hub services through delivery. CONCLUSION: Medicaid health plan care management alone can be insufficient in helping high risk pregnant women and their providers in reducing their risks of preterm delivery. Partnerships with community hubs reduces non-clinical/social determinant barriers in high-risk pregnancy. This data shows Community Hub activity combined with Medicaid health plan clinical program/care management activity improves birth outcomes in high risk pregnancies compared to high risk pregnancies that are not exposed to this intervention.