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‘Strong Start’ for Babies is Smart Way To Invest in Medicaid

Posted April 6, 2016

The best ways to improve health care do not always require new drugs, sophisticated technology or money. Common sense and compassion, as well as an understanding of human nature, can help us advance health and change lives.

One such effort in New Jersey is making a powerful difference in the lives of mothers and babies while costing very little. Strong Start for Mothers and Newborns is a program that should not just be continued — but also expanded.

I want to tell you about Strong Start as we move forward with Medicaid 2.0, our effort to re-envision Medicaid in New Jersey. We need to incorporate programs like this into the fabric of our state’s health insurance program for low-income residents.

How often have you read about an innovative program that successfully improved care and reduced costs? Research backed up the success. Then the funding ran out. The pilot lives on only in research papers and memories.

Strong Start supports pregnant women on Medicaid whose babies are at risk for birth complications because of unmet mental health needs, unstable housing, unemployment and other factors. The Central Jersey Family Health Consortium is one of 27 agencies running the program based on the CenteringPregnancy™ model. The consortium operates through a $1.7 million grant from the Center for Medicare and Medicaid Innovation and adds just $205 to the cost of each pregnancy, in addition to the usual charges. Strong Start operates at four hospitals, such as JFK Medical Center and Jersey Shore Medical Center, and three FQHCs in New Jersey.

Women with similar due dates join together for group pre-natal visits with their care providers. All the components of prenatal care are done together. The women weigh each other and learn about healthy pregnancies, often creating bonds and providing each other with social support throughout their pregnancies. A trained facilitator leads the discussion about pregnancy, birth, newborn care as well as other topics.

As I said, this is not high-tech. Yet the positive outcomes rival a new “break through” medication or technology.

A study just out in the Journal of Maternal and Child Health found that a CenteringPregnancy model in South Carolina reduced the risk of premature birth by 36 percent. That’s an astounding reduction. Each premature birth that was prevented saved Medicaid $22,667 in health care costs. Infants whose moms were in the program had a 44 percent reduction in low birth weight, saving nearly $30,000 for each baby not born too small. And there was a reduced risk of a NICU stay of 28 percent, saving $27,249 for each prevented NICU admission. Overall, the $1.7 million investment to fund the program saved the state’s Medicaid program $2.3 million. CMS also reported that women in the program had breastfeeding rates higher than the national average.

We know the savings extend beyond the initial health costs since babies born with complications may experience lasting and costly consequences, such as learning difficulties. And I believe the human cost is not calculable.

So is the plan now to expand these programs throughout New Jersey and the nation? Actually, federal funding for the New Jersey program ends this year. I believe we should not allow Strong Start to be another pilot that slips away, especially in New Jersey, where Medicaid pays for nearly one out of every three births.

Through Medicaid 2.0, an initiative funded by The Nicholson Foundation, we want to find better ways to deliver health care and then build these innovations into our Medicaid payment system. We want to create a blueprint for the future of Medicaid that makes the program more effective and more efficient. This program for moms and babies is a strong start.

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