Investing in Communities for Impact: Partnering for Perinatal Quality Care

Society’s most complex challenges require multi-faceted solutions. They call for sectors to come together to develop best practices, leverage their strengths and expertise, and drive towards solutions. UnitedHealthcare is working to engage in communities in new ways and invest in communities for impact. We are developing meaningful partnerships to support efforts to address gaps in the health and human services delivery system and scale best-practice solutions to address pressing health and social needs.

The opioid epidemic is a critical public health issue. Each day, approximately 130 Americans die from an opioid overdose.[1] Many Americans are personally impacted by the epidemic – one in five Americans report a personal connection to someone who has been addicted to opioids.[2] When opioids are used during pregnancy, babies can be born with a drug withdrawal syndrome called neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS). Approximately every 15 minutes, a baby is born with NOWS.[3]

UnitedHealthcare’s support and partnership with the Tennessee Initiative for Perinatal Quality Care (TIPQC) is a key example of how we are partnering with communities in meaningful ways to address critical health issues and increase access to evidence-based interventions.

The TIPQC is a collaborative of key stakeholders committed to improving health outcomes for mothers and newborns, In 2011 more than 600 babies in Tennessee were diagnosed with NOWS, an approximately eleven-fold increase since 1999.[4] Since 2011, the number of babies diagnosed with NOWS continues to grow. Last year the Tennessee Department of Health reported 881 cases[5].

Formed in 2012, TIPQC’s early work focused on the consistent application of best-practice protocols to optimize outcomes. UnitedHealthcare Community Plan of Tennessee was an early supporter of these efforts.

Since implementation, there have been important advances in research and care practices to address perinatal OUD. In March of this year, UnitedHealthcare announced support for a multi-year initiative with TIPQC to expand on its original NOWS program. With UnitedHealthcare’s support, TIPQC has incorporated updated best practices into its toolkit and is launching maternal and infant strategies to improve outcomes for both mother and baby.

The maternal arm of the project will engage provider teams at outpatient obstetric clinics, behavioral health programs, delivering hospitals, and birthing centers. The project will focus on education, resource mapping, protocol development, screening and referral procedures, and care coordination. The infant arm of the project will engage provider teams in delivery settings and will focus on implementation of evidence-based practices that improve outcomes and support family-centered care such as screening protocols, barriers to maternal/infant dyad care, and coordination with other support services. Participating sites will engage in monthly conference calls to share what is working and problem solve through challenges.

Our goal is to support TIPQC’s efforts through both funding and expertise. With UnitedHealthcare’s financial support, TIPQC will be able to expand their work more quickly and to more sites across the state. UnitedHealthcare is also contributing significant in-kind support. Optum Labs, a UnitedHealth Group collaborative research and innovation center, is providing technical assistance on data analytics and study design. UnitedHealthcare Community Plan of Tennessee’s clinical leadership is lending Medicaid expertise and aggregate claims data, and a UnitedHealthcare corporate staff member is providing cross-sector partnership and project management expertise.

The initiative leverages the expertise of UnitedHealthcare, TIPQC, and its other partners and sponsors to achieve optimal care outcomes for pregnant women with OUD and opioid exposed newborns.

Our collective goal with this work is to standardize care for perinatal OUD, improve family-centered care, and enable care in local communities. The maternal and infant project arms kicked off in March of this year, following a small pilot period. Next year the initiative will target Level 2 nurseries, followed by smaller more rural hospitals. Participating teams are committing to tracking data through a web-based data entry system. TIPQC will assess the success of new practices through measures such as the number of women with OUD receiving treatment during pregnancy and adequate prenatal care, increase in best practices like infants rooming-in with mothers, and length of pharmacologic treatment. We are proud to partner with TIPQC on its Optimizing Obstetric and Neonatal Care Opioid Use Disorder program and support their work to improve outcomes for women, babies, and communities across Tennessee. 

[1] Centers for Disease Control – Understanding the Epidemic

[2] Federal Reserve Board – Report on the Economic Well-Being of U.S. Households

[3] NIH - Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome

[4] TN Department of Health – Neonatal Abstinence Syndrome

[5] Ibid.

 

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