To help prevent complications
during pregnancy and birth, CIGNA HealthCare
recently announced the launch of CIGNA
Healthy Pregnancies, Healthy Babies,
a comprehensive maternity management program
that expands services offered to expectant
members to help improve their chances of
having healthy pregnancies and deliveries.
Approximately four million babies are born
in the United States each year1. Of these,
an estimated one in eight babies will be
born prematurely and an estimated 31 percent
of women will suffer some form of complication
during pregnancy2. Many birth complications,
which can potentially result in significant
harm to mother or child and additional health
care costs, can be prevented with proper
prenatal care.
"The greatest opportunity
to impact pregnancy outcomes is in the first
trimester and the early part of the second
trimester," said Jeff Kang, MD, chief
medical officer, CIGNA HealthCare. "Our
goal is to identify expectant mothers at
a greater risk for complications and lower
their risk of complications with patient
education, wellness programs and targeted
support from nurse case managers."
Employers are excited about
the program. "About 50% of Cisco's annual
medical claims costs are related to pregnancy.
If we can help our members ensure they are
receiving appropriate medical care and follow
up, we are hopeful we can help our mothers
have healthy pregnancies and fewer premature
infants. With appropriate outreach by CIGNA,
and a financial incentive added to the program,
we will encourage our employees to participate
in this program. We will track results over
time to better understand what works and
what does not so we can work with CIGNA to
improve the program in the years ahead," said
Pamela Hymel, MD, Cisco's Medical Director,
Integrated Health.
The CIGNA Healthy Pregnancies,
Healthy Babies program aims to identify members
with risk factors so they can begin a plan
of care early on that could help minimize
potential complications or premature births.
CIGNA's expanded program will provide incentives
for members to participate in the program
early in their pregnancy. The new program
will be available for plans that take effect
beginning January 1, 2007.
To encourage greater participation
in the program, CIGNA is offering eligible
members incentives to join the program. These
incentives may come in the form of reimbursement
of medical expenses, additional contributions
to a member's Health Reimbursement Arrangement
or other incentive arrangement. To encourage
members to join the program early in their
pregnancy, the value of the incentives would
be greater for members the earlier they join
the program. Members must complete the program
through the postpartum assessment to receive
the incentive payment.
In addition to helping members
have a healthy pregnancy and birth, this
program helps employers avoid potentially
significant costs associated with prematurity.
According to the March of Dimes®,
employers pay nearly 15 times more for babies
born prematurely in their first year of life
than for full-term babies. Beyond the direct
cost to business, premature birth also causes
lost productivity. The March of Dimes estimates
that premature babies spend nearly 17 days
in the hospital in their first year of life,
compared to two to three for full-term babies,
and they visit the doctor's office 50 percent
more often, resulting in more time away from
work for parents. The CIGNA Healthy Pregnancies,
Healthy Babies program helps reduce the financial
and emotional toll of pregnancy complications
for families and helps employers track and
reduce potentially high health and productivity
costs.
Eligible members can enroll
in the program by contacting CIGNA HealthCare
Member Services to be connected to the CIGNA
Healthy Pregnancies, Healthy Babies team.
Once enrolled, members undergo a comprehensive
health screening and receive a health management
plan tailored to their needs:
- Those identified as being at low risk
for pregnancy complications will receive
preventive education and screenings at
enrollment, five months gestation, seven
months gestation and postpartum.
- Participants identified as having moderate
risk for pregnancy complications will receive
additional interventions and monthly outreach
specifically targeted to their needs.
- Those identified as being at high risk
for complications will be referred to CIGNA
HealthCare's High Risk Maternity Program,
part of CIGNA HealthCare's specialty case
management program, to work with nurse
case managers and their treating providers
on a more intensive support plan based
on identified risk factors. Members with
specific medical conditions that impact
pregnancy outcomes, such as diabetes or
pregnancy-induced hypertension, will receive
support and care coordination to ensure
they understand their conditions and are
able to adhere to treatment recommended
by their providers.
The program will draw upon data and resources
available through CIGNA HealthCare and CIGNA
business units specializing in disability,
behavioral health, pharmacy management and
dental care. With the integration of information
from all of these health-related areas, CIGNA
Healthy Pregnancies, Healthy Babies clinicians
will be able to better understand the full
scope of an expectant member's condition
and care to help coordinate the appropriate
resources from many health disciplines for
the member.
Good dental care during pregnancy is important
too. Research shows that treating gum disease
may help reduce the likelihood of premature
birth for women at risk3. That’s why,
in addition to the Healthy Pregnancies, Healthy
Babies program, CIGNA HealthCare members
who also have CIGNA dental coverage have
access to the CIGNA Dental Oral Health Maternity
ProgramSM, which provides enhanced
dental benefits for pregnant members.
In addition, CIGNA works to raise awareness
of the risks of prematurity by supporting
the March of Dimes Prematurity Campaign and
as a leading fundraising team at WalkAmerica,
the March of Dimes' annual fundraising walk-
a-thon. Since 1995, CIGNA and its employees
have contributed $17.5 million to the March
of Dimes.
1 Centers for
Disease Control, National Center for
Health Statistics, based on 2003 data.
2 Danel, Isabella,
MS, MD, Berg, Cynthia, MD, MPH, Johnson,
Christopher, MS and Atrash, Hani, MD; "Magnitude
of Maternal Morbidity During Labor and
Delivery: United States, 1993-1997," American
Public Health Association, 2003.
3 August 2003,
Journal of Periodontology
