Supporting Statewide Initiative, BlueCross and BlueChoice Expand Prenatal Coverage
June 5, 2014
COLUMBIA, SC – Taking the next steps in a statewide effort to improve healthy birth rates, BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan of South Carolina are enhancing prenatal benefits with payments for two additional services.
Reimbursement began in May for SBIRT – screening, brief intervention and referral to treatment – in which physicians screen pregnant patients for depression, domestic violence, and tobacco, drug or alcohol use. They also make referrals for treatment if needed. This is included as preventive care required by the Affordable Care Act.
Effective June 1, enhanced coverage began for CenteringPregnancy® visits in which 10-12 women whose babies are due at about the same time participate in group visits. They receive routine medical care, have facilitated discussions, receive support and have an opportunity for community-building. Centering visits last much longer than a typical checkup — usually two hours. In addition to paying the global maternity rate, the insurers will make an incentive payment to the medical providers for each patient who attends a session and another payment if she attends five or more sessions.
BlueCross and BlueChoice® members may receive these CenteringPregnancy services at programs approved by the Boston-based Centering Healthcare Institute. In South Carolina, these are located at Greenville Health System’s OB/GYN Center, Mountain View OB/GYN in Easley, University Specialty Clinic at USC-Columbia, MUSC’s Department of OB-GYN in Charleston, Sumter OB-GYN, AnMed Health Family Medicine Residency Program in Anderson, Carolina OB-GYN in Georgetown and Murrells Inlet, Montgomery Center for Family Medicine in Greenwood and Carolina Women’s Center in Clinton.
“Pilot programs involving these services are showing improved birth outcomes, cost savings, and better informed and prepared parents. We expect that enhancing our traditional pregnancy coverage with these programs will result in healthier babies and mothers,” said Dr. Laura Long, MPH, chief medical officer and vice president of clinical innovation for BlueCross and for BlueChoice.
BlueChoice offers similar payments for its private health plan and Healthy Connections Medicaid members. In 2013, BlueChoice conducted a centering pilot for its Healthy Connections Medicaid members with Greenville Health System providers that involved 70 births.
“At this point, it is rare that insurance companies are providing these incentive payments for CenteringPregnancy,” said Lisa Summers, policy and advocacy director for the Centering Healthcare Institute. “BlueCross and BlueChoice in South Carolina are showing early leadership to the rest of the nation on this.”
Both companies are participating in South Carolina’s Birth Outcomes Initiative (BOI), a unique public-private sector program to decrease premature births and improve the health of the baby and mother (https://www.scdhhs.gov/organizations/boi). As part of the initiative, BlueCross, BlueChoice and the South Carolina Department of Health and Human Services, which administers Medicaid, stopped paying in 2013 for early elective deliveries — those occurring before 39 weeks gestation.
“The overall effort has resulted in better health for mothers and babies. We commend BlueCross as well as BlueChoice for their earlier participation and for taking these next steps to add new programs into their coverage. The March of Dimes — a member of the BOI — has supported CenteringPregnancy through our grants for many years, and we are delighted to have helped expand the program to sites throughout the state,” said Mona Carter, state director of the March of Dimes South Carolina chapter.
Headquartered in Columbia, S.C., and operating in South Carolina for more than 65 years, BlueCross BlueShield of South Carolina is an independent licensee of the national Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 40 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.
Also headquartered in Columbia, S.C., BlueChoice HealthPlan of South Carolina (www.BlueChoiceSC.com) is a member of the BlueCross BlueShield of South Carolina group of companies and holds its own independent license from the national Blue Cross and Blue Shield Association.
