I need to have these two paragraphs combined into one (although they are very similar). They need to make sense, have a good rationale. Basically I’m doing an analysis for my class. I have 2 sections Medicaid and Specialty. They each have 3 indicators which are mentioned above. All the information I sent you needs to be combined into one flowing paragraph.
In the last part. I would just add a rationale on how implementing would or a change in these areas would give a better birthing outcome.
For example
For ART; taking the medication while pregnant will improve because so and so
For each change being implemented a rationale does it make sense now?? Sorry this teacher is driving me nuts and I have to turn this in and I have a bunch of stuff to do
Another example
Preterm labor is a concern because ________
By improving adherence this will _____
5 hours ago
Medicaid: The 3 indicators are C-sections, Preterm birth, and NAS births
Specialty: Preterm birth, prenatal care, and ART adherence
These are the specific instructions given
Topic:
Clearly state the PIP topic. Explain how the topic was selected, addressing the following required criteria:
1. Was selected following collection and analysis of data. (Critical Element)
·Provide plan-specific data and analysis to support the selection of the topic.
·If no plan-specific data were available, provide rationale for why the data were not included.
2. Has the potential to affect member health, functional status, or satisfaction.
·The narrative should explain how the PIP topic has the potential to affect member health, functional status, or satisfaction.
·The link between the topic and outcomes of care should be explained.
Study Question
Do targeted interventions reduce the rates of?
a)Primary C-Section deliveries?
b)Pre-term deliveries?
c)Deliveries of infants with NAS?
Title:
(Medicaid)
Improving Birth Outcomes as Indicated by a Reduction in Preterm Births, C-Section Rates, and Neonatal Abstinence Syndrome (NAS) Births
Rationale:
I need to have these two paragraphs combined into one (although they are very similar). They need to make sense, have a good rationale. Basically I’m doing an analysis for my class. I have 2 sections Medicaid and Specialty. They each have 3 indicators which are mentioned above. All the information I sent you needs to be combined into one flowing paragraph.
In the last part. I would just add a rationale on how implementing would or a change in these areas would give a better birthing outcome.
For example
For ART; taking the medication while pregnant will improve because so and so
For each change being implemented a rationale does it make sense now?? Sorry this teacher is driving me nuts and I have to turn this in and I have a bunch of stuff to do
Another example
Preterm labor is a concern because ________
By improving adherence this will _____
5 hours ago
Medicaid: The 3 indicators are C-sections, Preterm birth, and NAS births
Specialty: Preterm birth, prenatal care, and ART adherence
These are the specific instructions given
Topic:
Clearly state the PIP topic. Explain how the topic was selected, addressing the following required criteria:
1. Was selected following collection and analysis of data. (Critical Element)
·Provide plan-specific data and analysis to support the selection of the topic.
·If no plan-specific data were available, provide rationale for why the data were not included.
2. Has the potential to affect member health, functional status, or satisfaction.
·The narrative should explain how the PIP topic has the potential to affect member health, functional status, or satisfaction.
·The link between the topic and outcomes of care should be explained.
Study Question
Do targeted interventions reduce the rates of?
a)Primary C-Section deliveries?
b)Pre-term deliveries?
c)Deliveries of infants with NAS?
Title:
(Medicaid)
Improving Birth Outcomes as Indicated by a Reduction in Preterm Births, C-Section Rates, and Neonatal Abstinence Syndrome (NAS) Births
Rationale:
The Plan is committed to ensuring optimal health outcomes for its members. Pregnant members are offered OB Case Management services to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child – C-Sections, preterm births, and NAS.
C-Sections – The federal government has set a goal of lowering the national C-section rate to 23.9 percent. Higher rates indicate there are probably women undergoing surgeries that are not medically necessary. Florida rates exceed the national goal; in the case of one Florida hospital, the C-Section rate was 68 percent.
Preterm Births – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.
NAS Births – Infants with NAS have prolonged hospital stays, experience serious medical complications, and place a tremendous strain on service systems. In Florida, sixty-two percent (62%) of babies born with NAS are covered by Medicaid.
NAS is associated with numerous central nervous system, gastrointestinal, as well as metabolic, vasomotor, and respiratory signs and symptoms, including high-pitched crying, seizures, sleep problems, poor feeding, diarrhea, poor weight gain, fever, nasal stuffiness, and rapid breathing.
Withdrawal signs will develop in 55% to 94% of newborns exposed to opioids in utero.
In Florida, NAS has increased from 592 (of 231,417) live births in 2008 to 1,411 (of 213,237) live births in 2011. During this time, racial/ethnic disparities existed such that NAS rates were substantially higher among non-Hispanic White infants than among non-Hispanic Black and Hispanic infants.
The number of hospital discharges for newborns diagnosed with NAS has increased 10-fold in Florida since 1995, far exceeding the 3-fold increase observed nationally. Notably, reporting of NAS varies by hospital because there is no statewide standardization for the diagnosis and reporting of substance exposed newborns. Therefore, statewide NAS data are likely underreported.
Sources:
·Florida Health:
·Florida Charts:http://www.flhealthcharts.com/ChartsReports/rdPage.aspx?rdReport=BirthAtlas.Dashboards.Birth_Atlas_Dashboard
·Health News Florida:
http://health.wusf.usf.edu/post/c-section-rates-extremely-high-florida#stream/0
Barriers and Proposed Interventions:
The Plan will establish an interdepartmental workgroup focused on improving birth outcomes and reducing C-Section rates, preterm births, and NAS births. The work group will be comprised of representatives from Case Management/Disease Management, Quality Management, Business Intelligence, and will be overseen by a Medical Director.
The workgroup will use data to identify and prioritize barriers to improvement in order to implement appropriate interventions. Barriers and interventions will be grouped into pre-conception, prenatal, and postnatal categories. Preliminary barriers have been identified and include difficulty engaging members who are substance users, inability to identify pregnant members without a claim or notification from the PCP or member, multiple data sources for each indicator that need to be modified into one comprehensive report.
Prior to developing new interventions, the Plan has compiled a list of its current OB-related processes and will review them to ensure they are tailored as needed to address the PIP indicators.
In addition, the Plan has committed to specific targeted interventions per study indicator. Those interventions are:
C-Sections:
-Member education campaign to educate on the risks of cesarean delivery vs. vaginal delivery
-Incentives to participating OB providers for providing increased access and improved quality of care and outcomes
-Alter reimbursement level or methodology for facilities with outlier rates of C-Sections
-Claims edits for detection and non-payment of non-medically necessary C-Sections to drive provider adherence
-Increase education to members of the availability of Birthing Centers and Midwifery
Preterm Births:
-Identification of PCPs/OBs who can certify in MAT to expand access for members with substance abuse
-OB Quality Incentive Program (OB QIP) to participating OB providers for providing increased access and improved quality of care and outcomes
-Ensure availability of office and home based Makena administration
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management of high risk members
-OB case management program manages all high-risk members including those with previous pre-term deliveries
-Taking Care of Baby and Me program – components include HRA, educational info, reminder calls, and potential incentives
NAS:
-Implement SUD and opioid CM program for detection prior to pregnancy with tailored initiatives to child bearing age population
-OB case management to educate members on smoking and substance abuse deleterious effects on the fetus
-Increase awareness of the availability to the use of LARC with members and providers
-Encourage providers to use E-FORCSE (Florida Prescription Drug Monitoring Program)
Provider incentives through OB QIP including prenatal substance abuse screening
Specialty Plan
Improving Birth Outcomes as Indicated by a Reduction in Preterm Deliveries, Increased Prenatal Care, and Improved Antiretroviral (ART) Adherence
Rationale:
The Plan is committed to ensuring optimal health outcomes for its members. Pregnant members are offered OB Case Management services, along with Care Coordination, to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child –preterm deliveries, prenatal care, and ART adherence.
According to the March of Dimes, there are an estimated 120,000 to 160,000 women in the United States who have been infected with HIV. About 6,000 to 7,000 of women infected with HIV give birth annually. Since the beginning of the HIV/AIDS epidemic, approximately 15,000 children in the United States have been infected with HIV and 3,000 children have died. About 90% of those were infected with the virus during pregnancy or birth.
Preterm Delivery – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.
Prenatal Care – A multi-care approach is the most effective way for pregnant women with HIV infection to have a healthy pregnancy and delivery. This approach will address the medical, psychological, and social challenges of pregnancy with HIV. A pregnant woman with HIV may also benefit from assistance with housing, food, child care, counseling support for herself and her partner. Substance abuse treatment and lifestyle counseling should be offered if needed.
Unless a complication should arise, there is no need to increase the number of prenatal visits. Special counseling about a healthy diet with attention given to preventing iron or vitamin deficiencies and weight loss as well as special interventions for sexually transmitted diseases or other infections (such as malaria, urinary tract infections, tuberculosis or respiratory infections) should be part of the prenatal care of HIV infected women.
ART Adherence – According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a 2% or less chance.
The United States Public Health Service recommends that HIV-infected pregnant women be offered a combination treatment with HIV-fighting drugs to help protect her health and to help prevent the infection from passing to the unborn baby.
Treatment during pregnancy has two goals: 1) to protect the expectant mother’s health, and 2) to help prevent passing HIV to the fetus. ART’s decrease the amount of HIV in the body thereby reducing the chance of transmission.
Sources:
·HIV and AIDS During Pregnancy:http://americanpregnancy.org/pregnancy-complications/hiv-aids-during-pregnancy/
·HIV and Pregnancy:https://www.acog.org/Patients/FAQs/HIV-and-Pregnancy
·Preterm Delivery, Low Birth Weight Unlikely with Perinatal HIV Treatment: https://www.poz.com/article/hiv-pregnancy-women-16825-1783
Barriers and Proposed Interventions:
The Plan will establish an interdepartmental workgroup focused on improving birth outcomes and reducing preterm deliveries, improving prenatal care, and improving ART adherence. The work group will be comprised of representatives from Case Management/Disease Management, Quality Management, Business Intelligence, and will be overseen by a Medical Director.
The workgroup will use data to identify and prioritize barriers to improvement in order to implement appropriate interventions. Barriers and interventions will be grouped into pre-conception, prenatal, and postnatal categories.
Prior to developing new interventions, the Plan has compiled a list of its current OB-related processes and will review them to ensure they are tailored as needed to address the PIP indicators.
In addition, the Plan committed to specific interventions per study indicators. These interventions are:
Preterm Deliveries:
-Ensure availability of office and home based Makena administration
-Partner with Targeted Outreach for Pregnant Women (TOPWA) providers
-Promote the participation in the Healthy Behaviors programs that would aid in healthy/full term pregnancies
-OB QIP to participating OB providers for providing increased access and improved quality of care and outcomes
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management for high risk members
Prenatal Care:
-Partner with TOPWA providers
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management for high risk members
-OB case management co-manages with HIV care coordinators to address Social Determinants of Health and HIV-related needs
-Specialized trainings conducted by the AIDS Education and Training Center (AETC) required for case managers
-OB QIP to participating OB providers for providing increased access and improved quality of care and outcomes
ART Adherence:
-Educate providers to prescribe a single tablet regimen vs. multiple to increase adherence
-Offer multiple methods of medication fulfillment, i.e., mail order and programs such as blister packaging vs. multiple bottles
-Share medication adherence data with PCPs and OBs
-OB case management – including member education on the consequences of ART non-adherence
-Enable pharmacy edits to identify instances of polypharmacy/duplication of therapys for its members. Pregnant members are offered OB Case Management services to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child – C-Sections, preterm births, and NAS.
C-Sections – The federal government has set a goal of lowering the national C-section rate to 23.9 percent. Higher rates indicate there are probably women undergoing surgeries that are not medically necessary. Florida rates exceed the national goal; in the case of one Florida hospital, the C-Section rate was 68 percent.
Preterm Births – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.
NAS Births – Infants with NAS have prolonged hospital stays, experience serious medical complications, and place a tremendous strain on service systems. In Florida, sixty-two percent (62%) of babies born with NAS are covered by Medicaid.
NAS is associated with numerous central nervous system, gastrointestinal, as well as metabolic, vasomotor, and respiratory signs and symptoms, including high-pitched crying, seizures, sleep problems, poor feeding, diarrhea, poor weight gain, fever, nasal stuffiness, and rapid breathing.
Withdrawal signs will develop in 55% to 94% of newborns exposed to opioids in utero.
In Florida, NAS has increased from 592 (of 231,417) live births in 2008 to 1,411 (of 213,237) live births in 2011. During this time, racial/ethnic disparities existed such that NAS rates were substantially higher among non-Hispanic White infants than among non-Hispanic Black and Hispanic infants.
The number of hospital discharges for newborns diagnosed with NAS has increased 10-fold in Florida since 1995, far exceeding the 3-fold increase observed nationally. Notably, reporting of NAS varies by hospital because there is no statewide standardization for the diagnosis and reporting of substance exposed newborns. Therefore, statewide NAS data are likely underreported.
Sources:
·Florida Health:
·Florida Charts:http://www.flhealthcharts.com/ChartsReports/rdPage.aspx?rdReport=BirthAtlas.Dashboards.Birth_Atlas_Dashboard
·Health News Florida:
http://health.wusf.usf.edu/post/c-section-rates-extremely-high-florida#stream/0
Barriers and Proposed Interventions:
The Plan will establish an interdepartmental workgroup focused on improving birth outcomes and reducing C-Section rates, preterm births, and NAS births. The work group will be comprised of representatives from Case Management/Disease Management, Quality Management, Business Intelligence, and will be overseen by a Medical Director.
The workgroup will use data to identify and prioritize barriers to improvement in order to implement appropriate interventions. Barriers and interventions will be grouped into pre-conception, prenatal, and postnatal categories. Preliminary barriers have been identified and include difficulty engaging members who are substance users, inability to identify pregnant members without a claim or notification from the PCP or member, multiple data sources for each indicator that need to be modified into one comprehensive report.
Prior to developing new interventions, the Plan has compiled a list of its current OB-related processes and will review them to ensure they are tailored as needed to address the PIP indicators.
In addition, the Plan has committed to specific targeted interventions per study indicator. Those interventions are:
C-Sections:
-Member education campaign to educate on the risks of cesarean delivery vs. vaginal delivery
-Incentives to participating OB providers for providing increased access and improved quality of care and outcomes
-Alter reimbursement level or methodology for facilities with outlier rates of C-Sections
-Claims edits for detection and non-payment of non-medically necessary C-Sections to drive provider adherence
-Increase education to members of the availability of Birthing Centers and Midwifery
Preterm Births:
-Identification of PCPs/OBs who can certify in MAT to expand access for members with substance abuse
-OB Quality Incentive Program (OB QIP) to participating OB providers for providing increased access and improved quality of care and outcomes
-Ensure availability of office and home based Makena administration
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management of high risk members
-OB case management program manages all high-risk members including those with previous pre-term deliveries
-Taking Care of Baby and Me program – components include HRA, educational info, reminder calls, and potential incentives
NAS:
-Implement SUD and opioid CM program for detection prior to pregnancy with tailored initiatives to child bearing age population
-OB case management to educate members on smoking and substance abuse deleterious effects on the fetus
-Increase awareness of the availability to the use of LARC with members and providers
-Encourage providers to use E-FORCSE (Florida Prescription Drug Monitoring Program)
Provider incentives through OB QIP including prenatal substance abuse screening
Specialty Plan
Improving Birth Outcomes as Indicated by a Reduction in Preterm Deliveries, Increased Prenatal Care, and Improved Antiretroviral (ART) Adherence
Rationale:
The Plan is committed to ensuring optimal health outcomes for its members. Pregnant members are offered OB Case Management services, along with Care Coordination, to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child –preterm deliveries, prenatal care, and ART adherence.
According to the March of Dimes, there are an estimated 120,000 to 160,000 women in the United States who have been infected with HIV. About 6,000 to 7,000 of women infected with HIV give birth annually. Since the beginning of the HIV/AIDS epidemic, approximately 15,000 children in the United States have been infected with HIV and 3,000 children have died. About 90% of those were infected with the virus during pregnancy or birth.
Preterm Delivery – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.
Prenatal Care – A multi-care approach is the most effective way for pregnant women with HIV infection to have a healthy pregnancy and delivery. This approach will address the medical, psychological, and social challenges of pregnancy with HIV. A pregnant woman with HIV may also benefit from assistance with housing, food, child care, counseling support for herself and her partner. Substance abuse treatment and lifestyle counseling should be offered if needed.
Unless a complication should arise, there is no need to increase the number of prenatal visits. Special counseling about a healthy diet with attention given to preventing iron or vitamin deficiencies and weight loss as well as special interventions for sexually transmitted diseases or other infections (such as malaria, urinary tract infections, tuberculosis or respiratory infections) should be part of the prenatal care of HIV infected women.
ART Adherence – According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a 2% or less chance.
The United States Public Health Service recommends that HIV-infected pregnant women be offered a combination treatment with HIV-fighting drugs to help protect her health and to help prevent the infection from passing to the unborn baby.
Treatment during pregnancy has two goals: 1) to protect the expectant mother’s health, and 2) to help prevent passing HIV to the fetus. ART’s decrease the amount of HIV in the body thereby reducing the chance of transmission.
Sources:
·HIV and AIDS During Pregnancy:http://americanpregnancy.org/pregnancy-complications/hiv-aids-during-pregnancy/
·HIV and Pregnancy:https://www.acog.org/Patients/FAQs/HIV-and-Pregnancy
·Preterm Delivery, Low Birth Weight Unlikely with Perinatal HIV Treatment: https://www.poz.com/article/hiv-pregnancy-women-16825-1783
Barriers and Proposed Interventions:
The Plan will establish an interdepartmental workgroup focused on improving birth outcomes and reducing preterm deliveries, improving prenatal care, and improving ART adherence. The work group will be comprised of representatives from Case Management/Disease Management, Quality Management, Business Intelligence, and will be overseen by a Medical Director.
The workgroup will use data to identify and prioritize barriers to improvement in order to implement appropriate interventions. Barriers and interventions will be grouped into pre-conception, prenatal, and postnatal categories.
Prior to developing new interventions, the Plan has compiled a list of its current OB-related processes and will review them to ensure they are tailored as needed to address the PIP indicators.
In addition, the Plan committed to specific interventions per study indicators. These interventions are:
Preterm Deliveries:
-Ensure availability of office and home based Makena administration
-Partner with Targeted Outreach for Pregnant Women (TOPWA) providers
-Promote the participation in the Healthy Behaviors programs that would aid in healthy/full term pregnancies
-OB QIP to participating OB providers for providing increased access and improved quality of care and outcomes
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management for high risk members
Prenatal Care:
-Partner with TOPWA providers
-Partner with Healthy Start for earlier notification of enrollment of pregnant members and management for high risk members
-OB case management co-manages with HIV care coordinators to address Social Determinants of Health and HIV-related needs
-Specialized trainings conducted by the AIDS Education and Training Center (AETC) required for case managers
-OB QIP to participating OB providers for providing increased access and improved quality of care and outcomes
ART Adherence:
-Educate providers to prescribe a single tablet regimen vs. multiple to increase adherence
-Offer multiple methods of medication fulfillment, i.e., mail order and programs such as blister packaging vs. multiple bottles
-Share medication adherence data with PCPs and OBs
-OB case management – including member education on the consequences of ART non-adherence
-Enable pharmacy edits to identify instances of polypharmacy/duplication of therapy
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