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Special delivery: HMO Arkansas develops program to identify and monitor state's high-risk pregnancies.

HMO Arkansas Inc. has come up with a plan to make sure the state's babies arrive "special delivery."

The Little Rock-based health maintenance organization introduced a program last month known as Special Delivery. It is designed to identify, educate and monitor mothers with what are considered high-risk pregnancies.

HMO Arkansas is an operating company of USAble Corp., a wholly owned subsidiary of Blue Cross and Blue Shield of Arkansas. Founded in 1948, Blue Cross and Blue Shield became a mutual insurance company in 1987. It is now the largest health-care insurer in the state.

Special Delivery attempts to ensure proper prenatal care for women who, for one reason or another, are likely to deliver low-birthweight babies.

"A normal delivery costs about $1,700," says Mike Brown, executive director of HMO Arkansas. "A premature delivery can cost $35,000 and go as high as $250,000 to $350,000, especially those with respiratory |problems~.

"We could be spending those dollars on a prenatal program to delivery healthy babies."

According to Brown, the average length of a baby's hospital stay following a normal delivery is two days. A premature delivery can lead to a hospital stay of 19 days, he says.

"As a health maintenance organization, one of our objectives is to provide preventive care," Brown says. "We felt this was an area that had been overlooked and needed some attention."

The program begins with a simple phone call.

Expectant mothers who belong to HMO Arkansas are asked to call a toll-free number by their 14th week of pregnancy. The telephone line is manned by a registered nurse, who asks the mothers preliminary questions regarding their pregnancies.

The purpose of the screening is to identify mothers who are considered at risk due to age, past medical problems, drug abuse, etc.

If a mother is found to be at risk, her obstetrician is contacted by HMO Arkansas.

"We advise them that if they need anything extra, we'll pay for it," Brown says. "We're not trying to interfere with the doctor-mother relationship. We're only trying to support them."

Keeping In Contact

The HMO Arkansas staff stays in contact with the at-risk mother's doctors during the entire pregnancy, making sure the mother visits a doctor at regular intervals.

"We also send them a packet of coupons for expectant mothers," Brown says. "Coupons for baby food, diapers."

Other components of Special Delivery are nutrition education and uterine monitoring to prevent early contractions that may lead to premature deliveries. Contractions, once discovered, can be slowed through drug therapy.

There is no additional charge for the program, available to the 20,000 members of HMO Arkansas and the 150,000 members of USAble Administrators. Like HMO Arkansas, USAble Administrators is an operating company of USAble Corp.

"We feel the savings, by reducing the change of low-birthweight babies, will more than offset the additional cost to HMO Arkansas," Brown says. "If we can avoid that $250,000 to $350,000 for a premature infant, we have saved that much for the HMO members."

Satisfied Customer

The Arkansas Farm Bureau Federation is one member of HMO Arkansas that already is enjoying the benefits of Special Delivery.

"One of our girls has received an impressive book, especially helpful for the first-time mother," says Ken Tillman, the rural health director for Farm Bureau. "So far, everything has been positive and upbeat."

Of the 220 Farm Bureau employees in central Arkansas, 190 are HMO Arkansas members, according to Tillman.

"These ladies are happy that someone cares enough that they will get a little extra special care," he says.

Thirty-five mothers have used Special Delivery at Farm Bureau, according to Brown. Fifteen are identified as being at risk.

Those considered the highest risks are diabetics, mothers who have suffered previous miscarriages and those who drink alcoholic beverages, smoke and take over-the-counter drugs. Age is another factor, Brown says.

"We have been in touch with two teen-age girls," he says. "We have them in nutritional counseling and parenting classes."

Dana Johnson, a registered nurse with HMO Arkansas, remembers one high-risk pregnancy that could have had an unhappy ending.

"The girl was identified as a high risk," Johnson says. "She was in her mid-20s, and she had suffered three previous miscarriages, one of them a full-term stillborn."

Johnson maintained contact with the woman during her pregnancy, which was carefully monitored.

"I saw her two weeks ago," Johnson says. "She had delivered a healthy, normal child. She was really ecstatic after all the sadness she's had in the past."

That mother beat the odds in Arkansas.

In 1989, there were 2,974 low-birthweight deliveries. That's 8.3 percent of the 35,893 babies born in the state.

Within the first year, 364 babies died. That's 10.1 per 1,000 births.

Brown sees Special Delivery creating a "win-win-win" effect.

"It's a win for the employer because there is no increase in their premiums," he says. "It's a win for the mother and family. And it's a win for the baby because a healthier baby escapes long-term care.

"Employers should recognize the gains. Prenatal care means healthier mothers, fewer absences and employees who are able to return to work earlier. You are able to keep valuable employees if you have a good, healthy delivery."
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No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991 Gale, Cengage Learning. All rights reserved.

Article Details
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Author:Taylor, Tim
Publication:Arkansas Business
Date:Nov 25, 1991
Words:876
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