The Strong Start for Mothers and Newborns initiative is working with hospitals to reduce premature births by reducing the number of early elective deliveries. This is a public-private partnership and awareness campaign to reduce the rate of non-medically indicated elective deliveries prior to 39 weeks, that builds on decades of work by organizations like The American Congress of Obstetricians and Gynecologist, the March of Dimes, the National Partnership for Women and Families, the Society for Maternal-Fetal Medicine, and Childbirth Connection. In addition, Strong Start’s goals and focus were identified with the help of experts at the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Administration for Children and Families (ACF) and Health Resources and Services Administration (HRSA).
Reducing the rate of early elective deliveries prior to 39 weeks ensures that more mothers receive safe, evidence-based care, and improves the prospects for good physical and developmental health for infants. It also reduces costs by safely reducing preventable C-section rates, neonatal intensive care admissions and other associated complications. CMS collaborated with Hospital Engagement networks across the country to identify and spread best practices to reduce potentially unnecessary early elective deliveries, which contributed to a 70.4% reduction in early elective deliveries between 2010 and 2013 among participating hospitals.
For example, the Ohio Perinatal Quality Collaborative used a range of interventions to shift almost 21,000 births from between 36 and 38 weeks' gestation to 39 weeks' gestation between September 2008 and October 2011. This shift reduced NICU admissions by 3% (approximately 621 admissions), which alone resulted in an estimated $24.8 million in savings for the three-year period. Almost half of these births were to mothers enrolled in Medicaid. Strong Start also is pursuing a four-year initiative to test new approaches to prenatal care and evaluate enhanced prenatal care interventions for women enrolled in Medicaid or CHIP who are at risk of having a preterm birth.
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