State officials, Blue Cross announce payment reforms aimed at improving birth outcomes for Louisiana newborns

Blue Cross and Blue Shield of Louisiana and Louisiana Medicaid will no longer pay for early elective deliveries of newborns before 39 weeks of gestation; reform will help give more Louisiana babies a healthy start

Wednesday, Sept. 3, 2014  |  Contact: Ken Pastorick; (225) 342-1881 or (225) 335-0235 (cell)

Baton Rouge, La. -- Louisiana Department of Health and Hospitals (DHH) Secretary Kathy H. Kliebert joined officials from Blue Cross and Blue Shield of Louisiana, and other health care leaders today in announcing a payment reform that will help Louisiana newborns have a head start on a healthy life. Effective Sept. 1, 2014, Blue Cross and Louisiana Medicaid will no longer pay for elective, medically unnecessary births of infants before 39 weeks of gestation. The change is expected to reduce the number of early elective deliveries by providers across the state and to reduce the number of costly health complications that lead many infants to have preventable medical challenges.

"All Louisiana children deserve the same opportunity for a healthy birth, one that reduces medical complications for both the mother and child, and that helps families take their infants home sooner," said DHH Secretary Kathy Kliebert. "Today's announcement takes us one step closer to that reality. I am so proud to call Blue Cross and Blue Shield a partner in reducing the number of early elective deliveries.  They, along with our health care partners in Louisiana, are making the wellbeing of newborns a priority."

"We want all of the moms and babies we cover to have the healthiest possible labor and delivery, so families can experience this special time with the joy that should be felt, not with the stress or fear of needing extra medical treatment," said Dr. David Carmouche, Blue Cross and Blue Shield of Louisiana Executive Vice President for External Operations and Chief Medical Officer. "Our 39-week policy is the latest step we are taking to protect the health of our newest and tiniest members."

Early elective deliveries are medically unnecessary deliveries of babies before 39 weeks of gestation. Those early elective deliveries may put the health of the newborn at risk and increase their likelihood of serious medical complications. Early elective deliveries are also far more costly.

Blue Cross joined the Medicaid program today in announcing that effective immediately, the health insurer will not cover elective deliveries, either C-section or induced natural birth before the 39th week of pregnancy.  Blue Cross will continue to cover any births before 39 weeks that are deemed medically necessary.

Louisiana's Medicaid program implemented a similar payment reform at the start of this fiscal year on July 1, 2014. The State legacy Medicaid and Bayou Health plans do not reimburse providers for early elective deliveries before 39 weeks.

"Today's announcement is an incredible step for Louisiana families, but we still have more work to do," said DHH Medicaid Medical Director Dr. Rebekah Gee. "Louisiana women consistently have the highest or second highest chance of ending up with a cesarean section in the United States.  Reducing all early elective deliveries before 41 weeks will go a long way toward reducing unnecessary cesarean sections.  Hospitals like Woman's and Ochsner have taken a strong leadership role in ending the practice of inductions before the cervix is dilated or "ripe" and have already shown reduced cesarean sections because of new policies."

"In 2007, Woman's was one of the first hospitals in Louisiana to no longer allow early elective deliveries before 39 weeks.  Since this strong stance, the number of critically ill newborns in our Newborn and Infant Intensive Care Unit (NICU) has reduced by 20 percent and our first time c-section rates have declined by 3 percent," explains Teri Fontenot, President and CEO of Woman's Hospital.

"Ochsner Health System has fully embraced the 39-week initiative across all of our medical centers in Southeast Louisiana," said Alfred Robichaux, MD, chairman of the Department of Obstetrics and Gynecology, Ochsner Health System. "We completely agree with this new standard for helping babies enter the world as healthy as possible and are proud to offer some of the state's most innovative and mother-baby focused programs at our Ochsner facilities."

Some of the nation's largest health organizations co-signed a letter earlier this year pledging to help reduce or eliminate all early elective deliveries across the country. The list of health care leaders included, the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Nurse Midwives (ACNM), the American College of Obstetricians and Gynecologists (ACOG), the American Hospital Association (AHA), the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), and the March of Dimes.

"We are pleased the 39 Weeks Initiative has continued to yield success towards improving birth outcomes for Louisiana's moms and babies, " said March of Dimes State Director Frankie Robertson.  "The March of Dimes commends Blue Cross and Blue Shield of Louisiana and the Department of Health and Hospitals for taking additional steps to reduce early elective deliveries without any medical indications.  We will continue to partner with various health agencies to promote long-term, systematic changes necessary to improve birth outcomes and reduce premature births."

Improving birth outcomes statewide is a major policy priority for DHH. The agency has focused on large-scale changes to improve how and when Louisiana children are born side by side with health care providers, insurers, hospitals and Louisiana parents. These changes have begun to reduce the number of Louisiana children born before 39 weeks while garnering support from key health care decision makers. Still, Louisiana has received a letter grade "F" for birth outcomes from the March of Dimes in recent years. Payment reforms like those announced today will likely not be reflected in reports on Louisiana's birth outcomes for several years, although the impact to Louisiana newborns can begin immediately.

More information on the 39-week initiative is available here: http://new.dhh.louisiana.gov/index.cfm/page/459. Information regarding March of Dimes' praise for DHH's 39-week initiative is available here: http://www.marchofdimes.org/news/print/march-of-dimes-president-commends-dhh-and-louisiana-hospitals-for-their-efforts-to-improve-birth-outcomes-in-louisiana.html.

The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about DHH, visit www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow DHH's Twitter account and Facebook.

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