March 21, 2016
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CMS releases results of initiative to improve newborn, mother health

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CMS released a series of findings on its Strong Start for Mothers and Newborns Strategy II initiative, stating the program, which seeks to improve maternal and infant health in low-income families, has increased the rate of breastfeeding and lowered preterm birth rates among at-risk participants.

The new results found in the second annual report for the initiative include preterm birth rates similar to national averages, despite participants being at high risk for giving birth prior to 37 weeks’ gestation. In addition, participants in the initiative had lower preterm birth rates than the national averages within the black, white and Hispanic racial-ethnic groups. Vaginal birth after cesarean rates among participants were nearly twice the national average, according to CMS.

“Much work remains to be done to reduce significant risks and complications for pregnant women and infants, but these early results from the Strong Start evaluation show promise for improving pregnancy outcomes,” Patrick Conway, MD, CMS principal deputy administrator and chief medical officer wrote in the agency’s blog. “We remain committed to working together to deliver higher quality care, smarter spending and better health outcomes for low-income women and their newborns.”

Other results in the second-year report, mirroring findings from the previous year, include lower rates of cesarean section births among participants than the national averages, although there was wide variation among and within models. In addition, both last year’s and the second annual reports indicated higher rates of breastfeeding among participants than the national averages in similar populations.

According to CMS, Strong Start Strategy II seeks to expand on the progress made by the Partnership for Patients and Strong Start Strategy I, which aimed to improve newborn health by reducing early elective deliveries.

Conway stated that Strong Start Strategy I had helped reduce early elective deliveries by 64.5% across the United States from 2010 to 2013.

Strategy II of the federal initiative seeks to address the psychosocial needs of pregnant women who are eligible for Medicaid and CHIP.

The initiative’s services include group care, including health assessments, education and support; birth centers, which offer prenatal care; and maternity care homes.

According to CMS, enrollment in the initiative is expected to reach more than 40,000 by Strategy II’s end in February 2017. Approximately 23,000 women entered the program from March 2013 to the end of the first quarter of 2015. In addition, the program boasts partnerships with 27 organizations representing 200 health care providers in 32 states, Washington, D.C., and Puerto Rico.

“Substantial progress was made during the second evaluation year in developing resources, particularly obtaining state Medicaid claims linked to vital records, which will enable development of a control group and an analysis of costs,” Conway wrote. “The third annual report is anticipated to contain analysis of further participant-level data, case studies based on site visits, and an initial analysis of linked data from states.” – by Jason Laday

Reference:

Conway P. CMS Blog. “CMS Strong Start for Mothers and Newborns Strategy II Initiative second annual evaluation report.” 2016.