June 2018

Before and After Care for Pregnant Patients

One indicator of population health is the infant mortality rate. Healthy People 2020 tracks this indicator as a vital statistic to improve health care and health outcomes. According to the Centers for Disease Control and Prevention, the infant mortality rate for the U.S. was 5.9 percent in 2016. The rates ranged from 0.0 percent in Vermont to 9.1 percent in Alabama. Although Texas’ rate of 5.7 percent was not the highest in the nation, the results have remained static since the 2015 measurement.

Preventing deaths of women and infants by ensuring appointment availability, identifying health risks, providing education and advocating for your patients is necessary to decrease the infant mortality rate.

As a provider, what is your action? Follow the HEDIS^® guidelines for prenatal and postpartum care to ensure your patients receive timely, appropriate care. Per HEDIS specifications, members are to be seen for prenatal care within their first trimester or within 42 days of enrollment into a Blue Cross and Blue Shield of Texas (BCBSTX) health plan. For postpartum care, members should be seen on or between 21 and 56 days after delivery.

Keep appointments open for members who are seeking prenatal and postpartum care, and reach out to members on your panel who have not scheduled their necessary prenatal or postpartum appointments.

Just announced from the Texas Medicaid & Healthcare Partnership, postpartum depression screenings are now a benefit for Texas Medicaid. Texas Health Steps (THSteps) medical providers may receive separate reimbursement for postpartum depression screening, in addition to the infant’s THSteps medical checkup or follow-up visit.

Maternity Program
BCBSTX members are encouraged to enroll in our maternity program, Special Beginnings^®*. Members receive educational materials and support, along with access to an online resource center and more. Providers can call the Medical Care Management Department at 1-855-896-2701 upon notification of any pregnancy to ensure your BCBSTX member can participate in the program. Members may call 1-888-421-7781 to enroll in Special Beginnings.

*BCBSTX reserves the right to discontinue or change this program at any time without notice. Special Beginnings can help plan and manage a member’s health, but is not a substitute for medical or other professional advice.

HEDIS is a registered trademark of NCQA.