Proven Results. Measurable Success.
Start Maternity Support Early
Timely identification and proactive engagement of your eligible pregnant members and employees delivers the best outcomes by using multiple data sources and telephonic Case Management outreach.
Our interdisciplinary team of obstetricians, neonatologists, pediatricians; maternity, pediatric and NICU nurses; social workers and lactation consultants collaborates on behalf of your members and employees.
Together, they deliver actionable, real-world services and support that build trusted, lasting relationships with your members from pregnancy up to 12 months:
- Identify pregnancies in a timely manner
- Improve maternal outcomes via proactive case management and key interventions
- Support members through focused SDoH and behavioral health coordination
- Offer educational and emotional support
- Help with the transition to home and back to work
Maternity Success by the Numbers
Enrollment
70%
of members who are successfully contacted enroll in the program
50%
of enrolled members are in their 1st or 2nd trimester
90%
of enrolled members are risk assessed—including depression and SDOH
Outcomes
23%
reduction in preterm births for our managed population
16%
reduction in ED utilization for our managed population
70%
of members that enroll while postpartum schedule a postpartum appointment
NICU Success by the Numbers
Savings
12-16%
in savings
90%
member satisfaction rate
Outcomes
10-15%
reduction in LOS
50%
reduction in readmissions
Ready for Any Complex and Costly NICU Admissions
In the event of a NICU admission, we support infants and families while lowering the overall cost of care.
Through every critical NICU milestone, our Care Management teams strive to ensure your newborn members, caregivers, and families get the right care at the right time and place.
Each newborn is assigned a dedicated NICU-experienced Utilization Management nurse, Case Management nurse or social worker, and a Medical Director to generate optimal results.
- Confirm accurate Levels of Care
- Manage Length of Stay
- Reduce ER visits and hospital readmissions
- Navigate families through life challenges
NICU Payment Validation & Assurance
Uncover lost savings related to NICU claims
NICU cases drive some of the highest rates of unwarranted spending. Our NICU Payment Validation & Assurance program reviews 100% of all NICU claims and flags the 28% with billing inconsistencies.
- Maximize NICU savings via hands-on reviews
- Align claim coding with clinical data from UM authorizations to ensure consistency and accuracy
- If there are no findings, there is no cost to you
NICU Payment Validation & Assurance by the Numbers
$7 – $10K
average savings per claim finding via NICU Payment Validation & Assurance
80%
of all NICU claims have some degree of inaccuracy
$1K – $3K
Average savings per NICU-managed member
Informed by more than 20 years of experience and patient data, ProgenyHealth’s end-to-end care management solution helps ensure the best possible outcomes for every expecting mother and family we encounter. Our wholly integrated, tech-enabled program builds a network of support for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life.
Suggested Reading
Innovations in Maternity Case Management
Health Plans Embrace an Integrated Approach to Improving Quality and Outcomes Across the Maternity Journey
SDoH Stories
SDoH: Solving Life’s Challenges and Improving Maternal & Infant Health through Proactive Case Management
2026 Trends Report: Policy, Peril, & Possibilities
The essential guide to the evolving landscape of maternal and infant health in America