Tailoring Prenatal Support with Practical and Clinical Engagement
Offering Education and Support
The member was invited to enroll in ICM’s Healthy Mother Baby Program early in her pregnancy following a precertification request for labor and delivery.
The member did not enroll immediately, but when she became sick with influenza and had to be hospitalized, she decided it would be helpful to receive additional support.
During a utilization review, ICM’s clinical team identified additional risk factors, including type 2 diabetes requiring insulin management. These findings significantly increased the complexity of the pregnancy and the risk for adverse outcomes.
Empowerment through Education
During the initial intake assessment, ICM’s Spanish-speaking nurse determined that the member was highly motivated to have a healthy pregnancy, but she lacked sufficient education related to diabetic management and nutrition to manage her diabetes and pregnancy safely. Instead of gaining 10 to 15 pounds as expected for her stage of pregnancy, misunderstandings over dietary restrictions and insulin use were causing her to lose weight.
ICM’s nurse coordinated directly with the physician’s office and diabetic educator to clarify the member’s care plan and provide additional educational support to the member.
Based on this collaboration:
- Blood glucose monitoring frequency was increased to double the usual number
- Insulin injections were increased
- Nutritional guidance was reinforced
The CDC says high blood sugar can increase the risk of health problems for pregnant women with diabetes, including:
- Birth defects
- Stillbirth
- Preterm birth
- Cesarean delivery
Source: CDC
Preventing a Crisis
In the seventh month of the pregnancy, the ICM nurse contacted the member during an evening outreach call and learned the member was experiencing contractions.
The ICM nurse provided immediate and extended education to help slow the contractions, and also reinforced the need for monitoring and follow-up. This timely intervention helped avoid a potential hospitalization and reduced the risk of preterm delivery.
The member went on to deliver a healthy, full-term baby.
The ICM Difference: Going the Extra Mile
ICM’s Healthy Mother Baby Program is defined by its willingness to do what it takes to keep members engaged in care. Case managers proactively uncover barriers to participation and adapt outreach accordingly, frequently conducting education and follow-up calls during evenings and weekends to align with members’ schedules, language needs and access limitations.
This level of flexibility and commitment drives healthier pregnancies while helping plans avoid unnecessary utilization and cost.
Meeting Members Where They Are
The member’s cell phone plan restricted daytime minutes but offered unlimited minutes during evenings and weekends. To support continuity of care while avoiding financial burden, the ICM nurse scheduled extended education and follow-up calls during evenings and weekends.
This is just one example of how ICM’s nurse tailored outreach to align with the member’s real-world limitations.
How Much Is Timely Intervention Worth?
A pre-term birth at seven months gestation could cost a health plan around $550,000, including NICU admission, pre-term labor admission, and extended neonatal care.
By providing timely intervention and education, ICM’S Healthy Mother Baby Program save the plan money while supporting a healthy delivery
Meeting Members Where They Are
The member’s cell phone plan restricted daytime minutes but offered unlimited minutes during evenings and weekends. To support continuity of care while avoiding financial burden, the ICM nurse scheduled extended education and follow-up calls during evenings and weekends.
This is just one example of how ICM’s nurse tailored outreach to align with the member’s real-world limitations.
Preventing a Crisis
In the seventh month of the pregnancy, the ICM nurse contacted the member during an evening outreach call and learned the member was experiencing contractions.
The ICM nurse provided immediate and extended education to help slow the contractions, and also reinforced the need for monitoring and follow-up. This timely intervention helped avoid a potential hospitalization and reduced the risk of preterm delivery.
The member went on to deliver a healthy, full-term baby.
The ICM Difference: Going the Extra Mile
ICM’s Healthy Mother Baby Program is defined by its willingness to do what it takes to keep members engaged in care. Case managers proactively uncover barriers to participation and adapt outreach accordingly, frequently conducting education and follow-up calls during evenings and weekends to align with members’ schedules, language needs and access limitations.
This level of flexibility and commitment drives healthier pregnancies while helping plans avoid unnecessary utilization and cost.
How Much Is Timely Intervention Worth?
A pre-term birth at seven months gestation could cost a health plan around $550,000, including NICU admission, pre-term labor admission, and extended neonatal care.
By providing timely intervention and education, ICM’S Healthy Mother Baby Program save the plan money while supporting a healthy delivery.