Making sure your clients are coveredFiled Under: Health Economics

Are Your Clients Covered?

Making sure your clients are covered

As an organization offering self-insured options to employers, you likely manage some mix of provider networks, quality of care, utilization management, case management, health care analytics, plan administration and more. But what if one of your clients faced a premature or medically complex birth? Do they have access to specialized NICU Care Management?

A NICU Care Management program is a key component of plan design; it helps manage high cost/stop-loss claims, reduces the financial burden on employees based on their out-of-pocket (OOP) obligations, and offers an attractive benefit for a child-bearing workforce.

ProgenyHealth NICU Care Management

With pre-term births nearing 10 percent of all newborn deliveries1, and 12 times more costly2, many self-insured plans add NICU Care Management to their offerings. ProgenyHealth is the only national company dedicated to improving care for infants in the Neonatal Intensive Care Unit (NICU). The ProgenyHealth Care Management program includes two components:

  • Utilization Management: ProgenyHealth uses data intelligence captured by its proprietary platform, Baby Trax® – based on nearly 100,000 NICU cases – to support the clinical decisions made by providers. By managing to an appropriate length of stay, monitoring levels of care, and verifying diagnostic codes, ProgenyHealth optimizes cost savings for self-insured employers while improving clinical outcomes.
  • Case Management: ProgenyHealth case managers work with families from the time of admission through the baby’s first year. They assist with discharge planning, screen for postpartum depression, provide information and clinical support, and help solve the Social Determinants of Health for new families.

Less Stress, Lower Costs, Fewer Readmissions

NICU infants in the ProgenyHealth program spend 17 percent less time in the hospital and are readmitted 50 percent less often on average,3 which means less money spent on care, less time away from work for parents, and a better quality of life for families. The program also reduces medical costs for NICU infants by 15 percent on average.4

Supporting Employee Retention

More than 75% of expectant mothers plan to go back to work after giving birth in the US,5 but once the baby comes home, 43% of them end up leaving their careers.6 Employees who fail to return from maternity leave end up costing an employer 20% to 213% of her former salary.7

To support employee retention, forward-thinking companies are increasing maternity leave. Yet, generous leave policies don’t automatically reduce the stress or solve the social determinants of health that accompany premature births. ProgenyHealth ensures that the newborn’s needs are overseen by a team of caring experts, from the moment they enter the NICU to the day they leave and even after everyone is back home and the baby reaches her first birthday.

Meet the Needs of Your Self-Funded Clients

To learn how your self-funded clients can add a program that attracts and retains their most talented employees and helps manage the risk of catastrophic NICU claims, download the white paper: Targeting Employee Benefits for a Forward-Thinking Workplace.

  • Preterm Birth (2019, July 23) Retrieved from
  • Truven Health Analytics, Inc., Costs of Preterm Birth, Prepared for March of Dimes, 2013.
  • Based on ProgenyHealth data.
  • In third year after launch of program based on health plan data.
  • “Modern Family Index 2016,” Bright Horizons Family Solutions.
  • Light, Paulette. “Why 43% of Women with Children Leave Their Jobs, and How to Get Them Back.” The Atlantic. April 19, 2013.
  • “Modern Family Index 2016,” Bright Horizons Family Solutions.
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