Prenatal care starts with free diapers

Medicaid managed care companies offer pregnant women and new moms free perks, including diapers, as an incentive to attend their prenatal and postpartum appointments.

A private company that manages Medicaid plans for thousands of South Carolinians recently started offering free diapers to pregnant women who show up for their prenatal appointments.

Moms who complete all their recommended office visits and a postpartum check-up qualify for a free stroller, portable crib or car seat.

“If you don’t get prenatal care, pretty much everything’s at stake: the health of the mom and the health of the baby,” said Dr. Robert London, WellCare of South Carolina’s senior medical director.

Other companies offer similar incentives. BlueCross BlueShield of South Carolina, for example, rewards Medicaid beneficiaries with car seats and gift cards for making their prenatal and postpartum appointments.

These perks benefit low-income patients and their babies, but they’re also intended to save insurers money. Companies who manage Medicaid benefits for the state stand to lose millions when infants are born too small or too early.

London said mothers who don’t see a doctor at least six times throughout their pregnancy will more likely deliver premature or low birth-weight babies, who may need treatment in neonatal intensive care units.

Each NICU admission costs more than $3,000 a day.

The South Carolina Medicaid agency pays WellCare, and similar companies, a flat monthly rate per Medicaid member to manage their benefits. The fewer NICU days the managed care companies must pay for, the more they will profit.

In a 2009 study, Harvard researchers determined these sort of managed care incentive programs work, “particularly among low-income women.” Patients were offered $100 to show up for their prenatal appointments and “participation in the incentive program was significantly associated with lower odds of neonatal intensive care unit admission.”

More than 57,000 babies were born in South Carolina in 2014 and 3,596 mothers who gave birth received fewer than five prenatal check-ups or none at all, according to the S.C. Department of Health and Environmental Control.

More than 4,300 infants were admitted to neonatal intensive care units across the state in 2014 and 372 died before their first birthday.

A 2015 Post and Courier investigation found inadequate prenatal care is closely tied to infant mortality. Babies in South Carolina will much more likely die during their first year if their mother received fewer than five prenatal check-ups.

“Daily, we outreach to our pregnant members as well as new moms and their babies to ensure they are getting the care they need to be healthy,” said Michael Saia, a spokesman for Select Health of South Carolina, another Medicaid managed care company.

Select Health offers new moms a $25 gift card when they complete a postpartum check-up within 56 days of delivery.

“We also offer assistance with overcoming barriers to care,” Saia said, “whether it’s help scheduling appointments, arranging transportation, filling prescriptions or providing translation services.”

More than 1 million adults and children are enrolled in Medicaid in South Carolina. The public program pays for more than half of all births in the state each year.

Reach Lauren Sausser at 843-937-5598.