Why Outsource Maternity and NICU Care Management?

Why Outsource Maternity and NICU Care Management?

Our clients agree: Internal Maternity & NICU Care Management programs are insufficient to deliver better outcomes while reducing the cost of care

Even if your plan has a robust case management program, supporting women through the entire reproductive cycle is challenging and requires dedicated expertise – particularly if a NICU event occurs. The low-volume/high-cost nature of these cases creates a unique set of challenges.

By engaging ProgenyHealth to assume care management of the entire process – from moderate/high-risk pregnancies to NICU births and postpartum issues – health plans can offer greater value to their members and enhanced support to their providers while delivering better health outcomes and lower cost of care.

Outsource Maternity Care Management to ProgenyHealth

ProgenyHealth is the only national company dedicated to Maternity & NICU Care Management. Founded by a pediatrician, our data-driven, clinical best-practices approach uniquely supports women, infants, and their families from conception up to the first year of the infant’s life.

By standardizing care management, solving SDoH challenges, reducing variations in care, and empowering families, we drive optimum quality outcomes at lower costs. We also ensure appropriate lengths of stay and levels of care should a NICU event occur — ultimately reducing inpatient costs, physician fees, emergency department visits, and readmissions.

  • Deep maternity care management experience – Our dedicated focus delivers unmatched expertise.
  • Proven ROI – Our integrated NICU Care Management and Payment Validation & Assurance services maximize program value year after year.
  • Proprietary Baby Trax® platform – Real-time predictive modeling, EHR, and AI-enhanced workflow management tools allow us to deliver individualized care management to every member.
  • Scalability and ease of onboarding – Knowledge of state-specific requirements coupled with our dedicated team streamlines program implementation.
  • High Satisfaction – Members, health plans, and providers give ProgenyHealth high marks.
  • Standardization of care – through national experience with local experience and insights, we consistently improve outcomes.

Our integrated Maternity & NICU Care Management program helps standardize care to bend the medical cost curve in the right direction

Our specialized team of obstetricians, neonatologists, pediatricians, maternity nurses, pediatric nurses, social workers, lactation consultants, and nutrition coaches collaborate to deliver better outcomes for women, infants, and families. Together with our plan partners, we make a difference – one woman, one baby, and one family at a time.

Contact us now to begin improving outcomes for your most vulnerable members.

Alarming NICU population trends

The US prematurity birth rate is now 10% and climbing. As cited in this Fact Book from the March of Dimes, the earlier a baby is born, the higher the risk of NICU admission and long-term disability. On an average day in the US:

  • 1,045 babies are born preterm (less than 37 weeks gestation)
  • 874 babies are born with low birth weight
  • Approximately 1 in 8 babies start life in the NICU – often driving the top 1% of utilization costs

Health plans don’t have sufficient NICU case volume to develop dedicated programs and specialist teams required to impact maternity/NICU outcomes and total cost of care.

Large employers can be significantly impacted by catastrophic claims and lost employee productivity related to these cases.

ProgenyHealth NICU UM CM solutions
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ProgenyHealth has helped to reduce our ALOS, reduce outlier days, and keep our readmission rates low. Testimonials from our members are full of praise.
- Health Plan CMO
Progeny has been an outstanding partner. Their clinical expertise in the NICU arena has helped us to manage the care of these infants effectively, and they are completely committed to identifying and addressing the social determinants of health often found in this fragile population.
- Marge Angello, Amerihealth Caritas’ Market President
Our medical management team worked closely with the experts at ProgenyHealth to deploy this integrated and very effective program. Their singular focus on NICU babies and their families was crucial to the program’s success, and especially vital in building a collaborative relationship with our providers. We’re very pleased with the outcomes of this initiative and the role it plays in our ongoing efforts to help members most at risk of developing serious chronic conditions.
- Dr. Michael Genord
Chief Executive Officer of Health Alliance Plan