Healthy Babies: HHS Adds an Initiative to Help Reduce Preterm Births

Feb 9, 2012, 7:32 PM, Posted by

Healthy Babies is the focus of the annual President’s Challenge of the Association of State and Territorial Health Officials, and this week the U.S. Department of Health and Human Services (HHS) put funding behind the issue as well, announcing the Start Strong initiative. The first activity of the initiative will be to give out more than $40 million in grants, through the Center for Medicare and Medicaid Innovation, to test ways to reduce the current high rate of premature births.

According to HHS, more than half a million infants are born prematurely in America each year, a rate that has grown by 36 percent over the last 20 years. Children born preterm are at risk for death and also often require significant medical attention, early intervention services and special education, and have conditions that may affect their productivity as adults.

The Center will award grants to health care providers and coalitions to improve prenatal care to women covered by Medicaid. The grants will support the testing of enhanced prenatal care through several approaches under evaluation, including:

  • group visits with other pregnant women,
  • birth centers providing case management, and
  • maternity care homes where pregnant women have expanded access to better coordinated, enhanced prenatal care.

The Strong Start initiative will also focus on reducing early elective deliveries, a goal shared by ASTHO and several partners including the Health Resource Services Administration and the March of Dimes. Up to 10 percent of all deliveries are scheduled as induced or surgical deliveries before 39 weeks that are not medically indicated. But any early delivery, planned or spontaneous, can carry medical risks for mother and infant.

In addition to health benefits, preventing preterm births can save money. HHS estimates show that medical care in the first year of life for preterm babies covered by the Medicaid program averages $20,000 compared to $2,100 for full-term infants. Medicaid pays for slightly less than half of the nation’s births each year. Even a 10 percent reduction in deliveries occurring prior to 39 weeks would generate over $75 million in annual Medicaid savings.

ASTHO, through its President’s Challenge, will be sharing best practices on reducing premature births and early elective deliveries and will be asking all state health officers to implement strategies based on successful national, regional, and state efforts. Among ASTHO’s goal is the opportunity to develop clear measurements to evaluate targeted outreach, progress, and return on investment, says David Lakey, MD, ASTHO President and Commissioner of the Texas Department of State Health Services. ASTHO, together with HRSA, held a preterm birth summit for Southern states in New Orleans a few weeks ago.

Dr. Lakey said a critical part of the summit was that each state team included decision makers such as Medicaid directors and representatives from the states’ governors. A key focus included health of mothers before pregnancy because risk factors such as obesity and smoking increase the risks of premature births. Equally key, said Lakey were avenues for disseminating best information to providers and mothers, such as Text4Baby. "We want to make sure that assets are available for people who need them," said Lakey.

Going forward, several state health officers have already made commitments to reduce prematurity by 8 percent by 2014, and "you’ll see more of that," said Lakey.


This commentary originally appeared on the RWJF New Public Health blog.