MONEY

Program seeks to reduce preterm births in Tennessee

Holly Fletcher
hfletcher@tennessean.com
Nurse Nancy Huguley checks 2-month-old Miller Green, who was born prematurely, while she visits a home Oct. 7 in Nashville.

Tennessee will be part of a pilot program to change prenatal care for women as UnitedHealth Group and March of Dimes partner on an initiative to tackle high preterm birth rates — a problem that is persistent across the state.

The duo want to get health systems and individual practices to implement a group prenatal care group so pregnant women have an opportunity to talk with women in the same stage of pregnancy, facilitated by a health care provider.

Tennessee gets a D grade from March of Dimes, a nonprofit focused on pregnancy and the health of babies, for its preterm birth rates. Memphis has the highest preterm birth rate at 13.7 percent. Nashville comes in fourth with 10.1 percent. The state's average is 10.8 percent.

Women in care groups have shown better outcomes in studies that looked at preterm births in low-income women, said Dr. Deneen Vojta, executive vice president of enterprise research and development at UnitedHealth Group.

Nationally, March of Dimes is trying to reduce the country's preterm birth rate to 5.5 percent by 2030, from about 9.6 percent in 2015. The goal is to reduce the number of births that happen between 34 and 36 weeks.

Vojta said prenatal care that better teaches women how to be healthy and pregnant can go a long way to bringing more babies to term.

Tennessee was selected because of its high number of preterm births and a willingness from health care providers in the state to try new ideas, Vojta said.

Dr. Deneen Vojta

Premature births, even by a few weeks, can lead to more health care costs in addition to health struggles as the baby grows up. According to the Institute of Medicine, costs of preterm births hit $26.2 billion in 2006, which accounts for more than one-third of health care spending on infants in the U.S.

Davidson County public health officials recently analyzed the preterm births by neighborhood and found a wide discrepancy. Babies born to women who live in The Nations and North Nashville were twice as likely to have a low birth weight or be preterm than those born to women who live in Sylvan Park, the neighborhood on the other side of Charlotte Pike.

Parents with children born too early can struggle with medical needs — a struggle for many who already have tight budgets.

"It’s a bigger problem than the pure numbers themselves,” Vojta said.

Born healthy? It depends on where you live

The program in Tennessee will be open to all women who are patients of a participating provider or health system regardless of insurance status, Vojta said. The group will be open to women with insurance from carriers besides UnitedHealthcare or those who are uninsured.

Women will attend 10 two-hour sessions that will cover a variety of topics and include individual assessments by a provider.

Jim Merwin

The session would replace the traditional appointment where women often spend considerable time waiting, said Jim Merwin, director of product and operations for UnitedHealth Group.

"It’s really not much more time than that," but the women are interacting with other women in similar situations under the supervision of a medical professional, Merwin said.

Participants get the chance to talk about struggles that come up in pregnancy, some of which probably wouldn't come up during the routine, short individual exam. The group could share tips on how to deal with hunger between meals if they are trying to limit weight gain, for example, or how to handle issues that arrive with partners, both real world problems that can impact physical and mental health during pregnancy, Vojta said.

UnitedHealth Group is working with March of Dimes on identifying health systems and practices that want to participate. The duo has a playbook to help providers implement a care group program that advises on details down to the size of the room needed to accommodate 10 women..

Often the physicians and those who lead the sessions have to learn how to facilitate and engage instead of speaking too clinically, Merwin said. The first group sessions are expected to start in January.

Reach Holly Fletcher at 615-259-8287 or on Twitter @hollyfletcher.