Goal: To improve birth outcomes and reduce Medicaid costs by fostering a population of healthier Louisiana women
National surveys indicate that opportunities for preventive care and health promotion among women are largely missed. The Kaiser Family Foundation 2005 survey of women aged 18 to 44 found that just over half of the of the women had spoken with a health provider in the previous three years about diet, exercise or nutrition; less than half had discussed calcium intake, smoking and alcohol use. Diabetes, hypertension, sexually transmitted diseases, obesity, smoking, heavy alcohol use and depression, for example, all affect a woman's long-term health and can contribute to high-risk pregnancies and babies being born too small, too soon, or sick.
While Medicaid finances nearly 70 percent of births in our state, among the highest in the nation, it is less likely as, are other states, to provide health coverage before and after pregnancy. Medicaid eligibility ends 60 days postpartum for 73 percent of women in Louisiana whose maternity care was financed by Medicaid. Many women will have a subsequent Medicaid-financed birth with a high-cost, adverse pregnancy outcome before their medical and psychosocial risks are addressed.
Experts have identified evidence-based interventions that can be delivered before a woman becomes pregnant to reduce the chances of an adverse outcome for mother and baby - the aim is to improve "preconception" health. Preconception and interconception care must be a core component of women's primary health services. Preconception care occurs before a first pregnancy, while interconception care happens between pregnancies. The purpose is to provide health promotion, screening and interventions for women of childbearing age to reduce risk factors that might affect future pregnancies. It begins with understanding a woman's reproductive health plan. Currently, many women do not receive these services due to lack of health coverage.
Through BOI, DHH will seek to improve preconception and interconception health for women at high risk of poor birth outcomes in Louisiana.