Continuing the long tradition of developing products that fit the needs of our members, Start Smart for Your Baby® is a cornerstone of Centene's suite of innovative medical programs. In 2008, three physicians at Centene (an obstetrician, a pediatrician, and an internist) developed a pregnancy management program called Start Smart for Your Baby®. The program incorporates care management, care coordination, and health education in an effort to improve maternal and infant health. The award-winning education and outreach program focuses on pregnant members, new moms, and their babies.

In 2016, preterm birth affected about one of every 10 infants born in the United States, and 1 in 8 infants covered by Medicaid is born premature. Start Smart for Your Baby® promotes member engagement to achieve healthy pregnancies while preventing premature births and admission to neonatal intensive care units. Infants born preterm or at low birth weight can experience severe health and developmental difficulties. Babies born prematurely may have long-term health problems, including increased risk of:

• cerebral palsy
• blindness
• deafness
• developmental delay
• diabetes
• heart disease
• high blood pressure
• metabolic syndrome
• obesity

Centene health plans manage over 200,000 deliveries each year. Approximately 30% of these deliveries are high-risk, and 30% of the high-risk deliveries are engaged in care management. Identifying high-risk pregnant members and intervening early can lead to better birth outcomes. Nearly 1.2 million babies have been born to health plan members since the program launched ten years ago.   

One of the essential components of the program is the Notification of Pregnancy (NOP) process, which identifies pregnant members and their risk factors as early as possible in order to establish a relationship between the member, provider, and health plan staff. The percentage of births with an NOP on file increased from 10.55% in 2007 to 61.10% in 2017.

Normal weight at term delivery is 2500-4200 g (ranging from 5 pounds, 8 ounces to 9 pounds, 4 ounces). Low birth weight is the birth weight of an infant at 2,499 g or less. Subcategories include very low birth weight which is less than 1500 g (3 pounds, 5 ounces), and extremely low birth weight, which is less than 1000 g (2 pounds, 3 ounces).

As program participation increased, low and very low birth weight deliveries have decreased. Using statistical analysis methods, estimates indicate that participants are:

• 7.9% less likely to have a baby born at a low birth weight, under 2500 g
• 20% less likely to have a baby born at a very low birth weight, under 1500 g
• 31.2% % less likely to have a baby born at an extremely low birth weight, under 1000 g

Improving the health outcomes of some of our most vulnerable members means using the best possible tools. A wide range of care management techniques aim to improve obstetric and pediatric care services while reducing pregnancy-related complications, premature deliveries, low birth weight deliveries, and infant disease. Reductions in the number of low birth weight deliveries improve health outcomes, while outreach activities connect members with clinical teams, care coordinators, and community partners in a fun and engaging setting.

The outcomes of this program have been impressive. SSFB has had a drastic increase of program participants since its inception, and the program has demonstrated a statistically significant improvement in delivery outcomes.

As part of the suite of programs run by Centene's Clinical Programs team, we're confident that Start Smart for Your Baby® will continue to set industry standards. We look forward to celebrating its successes for years to come!