WMP Project - Women's Health Services Plan Selection, Neonatal ICU Services
The Affordable Care Act of 2014 made neonatal care mandatory for all health maternal coverage. Research posits that some factors that women, especially those with high-risk pregnancies, consider when selecting a health plan include full coverage for high-risk newborn care, length of coverage, and quality of care. There are a number of healthcare plans available to women to the U.S. that cover neonatal intensive care services. These are Medicaid, Children Health Insurance Plan (CHIP), employer-provided insurance, and individual marketplace insurance plans.
- In the U.S., nearly half a million children are born preterm and it is estimated that 85% of neonatal fatalities are a result of preterm birth and the complications that arise thereof. Effective prevention and management of high-risk pregnancies have been identified as a viable solution to reduce neonatal mortality, which can only be made possible by comprehensive maternal care coverage.
- Neonatal Intensive Care Units are among the most expensive healthcare services given in hospitals, thus it is imperative that its full coverage is included in the maternal health plans women choose.
- Medicaid, for instance, covers nearly half of U.S. pregnancies, with many of those being high-risk. High risk neonatal care is receiving more funding from this federal insurance plan, as Medicaid is used in most states as an "essential cover" for babies born with complications. This is an important consideration for women, especially those with a history or potential for high-risk pregnancies.
Quality of Care and Facility
- Further research identified that longer coverage alone cannot reduce neonatal mortality from high-risk pregnancies, but it must be accompanied by improved quality of care. Reputation for care has been cited by women as a top contender for why they choose facilities and the plans that cover them.
- Women say that they are more likely to choose a hospital with access to a pediatrician and neonatal intensive care units (NICU) than those without, even if it means traveling out of their locale. Access to quality neonatal care services is an important consideration for women when looking for maternal coverage. Research shows that there are improved outcomes for high-risk births who are born in facilities equipped with NICU.
- Excellent in-network care is also a consideration for women looking for maternal care. Research cites that quality of care and communication, as well as bedside manners of staff, are environmental support factors that mothers expect in an NICU, thus these factors heavily dictate which facilities they will use, and conversely what healthcare plan they will choose.
Length of Coverage
- Women would like to determine the length of their stay in hospital after birth. Thus, the length of maternal coverage, especially that given to neonatal care, is a top consideration in choosing healthcare plans.
- Neonatal admission has increased from 64 to 79 per 1000 live births, and the average days spent by a newborn in NICU is 13.2 days for infants born between 39-41 weeks and 46.2 days among infants born with a gestation period below 32 weeks.
- Medicaid, which offers essential coverage for babies born with complications, offers a 60-day coverage for the mother, and once born, the child is eligible for Medicaid coverage until the first year of their life.
- Most insurance plans give parents a 30-day window after their child's birth to add them to their insurance for adequate cover. Those with marketplace coverage have until 60 days to enroll their newborns.
To establish the factors that women with potential for high-risk pregnancies consider when choosing a healthcare plan, your research team did a general search of high-risk pregnancy care in the given scope. This yielded various results that led to further narrowing down on how various insurance plans cater to this segment. A few studies on preferences and attitudes of American women around birth and the healthcare received after further shed insights into what women consider when selecting a healthcare plan, specifically that cover neonatal intensive care services.