Improving Quality of Maternity Care for Medicaid Beneficiaries in Nevada – A New Partnership Offers Promise

Improving Quality of Maternity Care for Medicaid Beneficiaries in Nevada – A New Partnership Offers Promise

Value-Based Care, Providers, Medicaid, Maternity

The maternal health crisis in this country hits far too close to home for states like Nevada, where preterm birth rates, infant mortality rates and gaps in health equity recently earned the state a D- grade from the March of Dimes. Maternity care deserts are partially to blame for the state’s maternal health outcomes. More than half of Nevada’s 17 counties do not have a hospital or birth center that offers obstetric care.

 

Poor outcomes and lack of access to care disproportionately affect women who live in rural areas and/or are on Medicaid. To address this reality, leading plans and providers in Nevada are working tirelessly to solve core issues with access, quality, equity and patient/provider experience. This includes SilverSummit Healthplan, a managed care organization that provides healthcare services to Nevada Medicaid and Nevada Check Up members in Clark and Washoe counties. It is a wholly-owned subsidiary of Centene Corporation. In total, the plan supports more than 2,000 Medicaid births each year.

“In Nevada, we have an amazing network of OB providers, innovative health plans and access to emerging technologies that support maternal health, but what’s been missing is bringing all of these pieces together in a way that more effectively cares for expectant mothers,” said Dr. Steven Evans, chief medical officer for SilverSummit.“It’s clear that women across the state, and specifically our members, have unmet needs when it comes to maternity care.” 

The plan is innovating in several areas as a result, including a new partnership with the region’s leading OB practices and Wildflower Health. 

“We are confident this effort will boost quality and improve the overall experience for the women we serve," Dr. Evans said. 


Laser Focus on the Most Critical Metrics

This partnership is aimed at addressing a range of HEDIS measures that significantly impact maternal health outcomes in order to nurture healthier pregnancies and births for Nevada mothers and their babies. Specifically, this initiative will improve quality of maternity care in the following ways:

  1. Ensuring timeliness and adherence to prenatal and postpartum care by empowering members to actively participate in their health  
  2. Reducing both C-section rates and number of NICU admissions by proactively managing pregnancies and addressing complications
  3. Improving health equity by more effectively identifying health disparities and SDoH needs and connecting members to health plan and community resources
  4. Enhancing behavioral health support by increasing the number of moms screened for clinical depression during pregnancy and postpartum, as well as more effectively connecting women with positive screenings to appropriate interventions
  5. Increasing the rate of prenatal immunizations for influenza and tetanus, diphtheria toxoids and acellular pertussis (Tdap)

Shared Platform with Regional OBs

To ensure a deeper level of care coordination and holistic support for members, local OB providers are highly engaged. Women’s Health Associates of Southern Nevada (WHASN) and other leading practices across the SilverSummit coverage region are participating in this initiative through a networked digital experience. Patients are automatically connected to a digital app and Health Advocates via a shared platform that is integrated with each practice’s EMR. 
 

“In our experience, patients are hungry for good information during pregnancy and are extremely interested in engaging with digital tools and receiving additional support,” said Dr. Rebecca Herrero, president & CEO of Women’s Health Associates of Southern Nevada and a member of SilverSummit’s physician advisory board.  “We are very excited to be one of the OB groups participating in this initiative. This helps our practice extend and expand the care we deliver to expectant mothers in a truly meaningful way.” 

WHASN is a group of board-certified and board-eligible obstetricians and gynecologists with 20 care centers serving areas including Las Vegas, North Las Vegas and Henderson, delivering more than 3,700 babies so far in 2023.

Robust Digital Tools and Health Advocacy 

To ensure deep coordination and collaboration between the plan, regional OBs and patients, this partnership will provide SilverSummit members access to a robust digital application that dynamically supports their evolving needs throughout pregnancy and postpartum. The application includes an extensive collection of evidence-based health articles and accompanying to do lists of important actions specific to mom’s health needs or current treatment. Health surveys and SilverSummit or OB resources align to provide a personalized experience and easy connections to needed resources.

Members who need additional support have access to Health Advocates, who deliver health education, care coordination, care escalation and remote monitoring, as needed. Health Advocates follow up with members to encourage adherence to physician care plans and provide referrals to health plan, OB and community resources. 

Health Advocates also escalate members when urgent needs arise, such as a high maternal mental health survey score or high blood pressure. Depending on the need, escalations are routed to the health plan and the provider so the patient has the most comprehensive support. Health Advocates can also facilitate remote monitoring device needs, such as blood pressure cuffs for members with a diagnosis of hypertension and glucometers for members who have a diagnosis of diabetes, as determined by their provider.

The Value of Partnership

This partnership will help SilverSummit identify member needs sooner and more effectively support individuals throughout their pregnancies. For providers, it helps them extend quality care between visits, reinforce care plans for moms who have higher-risk pregnancies and gain a more holistic view of the women under their care. For patients, it creates a seamless experience where they can benefit from an array of support available through their provider, their health plan and their local community. This takes a lot of the guesswork and uncertainty out of the healthcare experience and provides a uniquely personalized journey for every woman.
 

“SilverSummit has made a long-standing commitment to high-quality, individualized care for women,“ said Leah Sparks, founder and CEO of Wildflower. “In addition to helping the health plan improve quality and enhance the health of its members, this effort will also establish a solid foundation for SilverSummit to further innovate in the future, including the exploration of full value-based models for maternity care.” 

As an example of the impact this partnershp will have on expectant mothers, consider the story of Bobbi. Because this program exists, individuals like bobbi will receive much more comprehensive and personalized care. Below, you'll see a list of needs we have identified for Bobbi, and various ways we are supporting her in her pregnancy journey. None of this would be possible without providing more resources to patietns and ensuring tighter collaboration between the health plan and the provider. 

Want to learn more about SilverSummit’s initiative in Nevada, or how your organization can support deeper collaboration while improving maternal health outcomes in your region? Contact us today!