published Monday, March 25th, 2013

Georgia to end Medicaid payments for some early births

ATLANTA — Georgia health officials are hoping to improve care — and save money — by steering pregnant women and doctors away from some early deliveries.

State officials are doing this by eliminating Medicaid payments for elective C-sections and induced deliveries before 39 weeks, The Atlanta Journal-Constitution reported.

The move, which will take effect July 1, will save the state’s ailing Medicaid health program for the poor an estimated $7 million this fiscal year and next by avoiding costly medical complications and stays in neonatal intensive care units.

“This was a policy decision that will result in better health outcomes for Georgia families,” said Christopher Schrimpf, a spokesman for the Georgia Department of Community Health, which oversees Medicaid. “But it also has a secondary benefit of being financially sound.”

The state’s Medicaid budget is facing a nearly $400 million hole despite tens of millions of dollars in proposed cuts over the next couple of years.

A mother waiting at least 37 weeks to give birth was long the industry standard. Several studies in recent years, however, have shown that babies born even a week or less prior to 39 weeks are more likely to have development problems and need specialized hospital care, the Journal-Constitution reported.

There is a short-term cost with babies having to stay in neonatal intensive care, as well as the long-term costs of caring for developmentally delayed children, said Dr. Dean Greeson, chief medical officer for Peach State Health Plan, which provides health coverage to pregnant women on Medicaid.

“The state saw this as a way to get at both of those issues,” Greeson said.

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