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HHS launches Strong Start initiative to increase healthy deliveries and reduce preterm births

Article / Review by on February 8, 2012 – 7:30 pmNo Comments

HHS launches Strong Start initiative to increase healthy deliveries and reduce preterm births

To help reduce the increasing number of preterm births in America and ensure more babies are born healthy, HHS Secretary Kathleen Sebelius announced more than $40 million in grants to test ways to reverse that trend, as well as a public campaign to reduce early elective deliveries.

Health and Human Services Secretary Kathleen Sebelius

“Preterm births are a growing public health problem that has significant consequences for families well into a child’s life,” said HHS Secretary Kathleen Sebelius.  “The Strong Start initiative will help give expectant mothers the care they need for a healthy delivery and a healthy baby.”

More than half a million infants are born prematurely in America each year, a trend that has skyrocketed by 36 percent over the last 20 years.  Children born preterm require additional medical attention and often require early intervention services, special education and have conditions that may affect their productivity as adults.

To tackle this problem, the Center for Medicare and Medicaid Innovation will award grants to healthcare providers and coalitions to improve prenatal care to women covered by Medicaid. The grants will support the testing of enhanced prenatal care through several approaches under evaluation, including through group visits with other pregnant women, at birth centers providing case management, and at maternity care homes where pregnant women have expanded access to better coordinated, enhanced prenatal care.

In addition to preventable preterm births, the Strong Start initiative will also focus on reducing early elective deliveries, which can lead to a variety of health problems for mothers and infants.  Up to 10 percent of all deliveries are scheduled as induced or surgical deliveries before 39 weeks that are not medically indicated. However, any early delivery, planned or spontaneous, can carry medical risks for mother and infant. According to research by organizations such as the American College of Obstetricians and Gynecologists (ACOG), the March of Dimes and others, elective deliveries before 39 weeks increase the risk of significant complications for mother and baby, as well as long-term health problems.

As part of the Strong Start campaign, CMS will also work with hospitals across the country that have joined the Partnership for Patients – a national, voluntary effort to improve safety and reduce avoidable harm, including obstetric harm that may stem from early elective deliveries.

“As a nurse, I know the importance of prenatal care and the risks associated with early deliveries,” said CMS Acting Administrator Marilyn Tavenner. “Through Strong Start we hope to learn the most effective ways to prevent preterm births and to promote those activities across all providers as well as payers, public and private, to improve the health of all mothers and their infants.”

The Strong Start initiative cuts across many agencies within HHS and will involve efforts by the CMS, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Administration on Children and Families.

HHS will also work with a variety of professional organizations including, the March of Dimes, ACOG, and other organizations.

“The American College of Obstetricians and Gynecologists is proud to partner with the Department of Health and Human Services and the March of Dimes on one of the most certain ways of helping babies get a good start in life:  Delivering no baby earlier than 39 weeks, unless medical or obstetric complications require otherwise to keep mother and child safe,” said Hal C. Lawrence, III, MD, Executive Vice President of the American College of Obstetricians and Gynecologists. “Our joint initiative will help bring this important information to women and physicians across the Nation, and has enormous potential to make a real and lasting change in how we care for expectant moms, and more importantly, how expectant moms expect us to care for them.”

“Premature birth is a serious health problem and the public and private collaboration that will be generated by the Strong Start initiative is the single most important step forward to date in our nation’s prematurity prevention efforts,” said Jennifer L. Howse, President of the March of Dimes. “Working together to eliminate medically unnecessary early deliveries will reduce the emotional and financial burden of prematurity for thousands of families.”

In addition to health benefits, preventing preterm births can save money for the health care system. It is estimated that medical care in the first year of life for preterm babies covered by the Medicaid program averages $20,000 compared to $2,100 for full-term infants.  Medicaid pays for slightly less than half of the nation’s births each year.  Even a 10 percent reduction in deliveries occurring prior to 39 weeks would generate over $75 million in annual Medicaid savings.

Initial funding for Strong Start will be for the delivery and testing of enhanced prenatal care through renewable grants.

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More information on the grants announced today and to learn more about efforts to reduce preterm births and early elective deliveries:

Strong Start for Mothers and Newborns

This initiative is a joint effort between the Centers for Medicare & Medicaid Services (CMS), the Health Resources and Services Administration (HRSA), and the Administration on Children and Families (ACF).

Overview

The Strong Start initiative supports reducing the risk of significant complications and long-term health problems for both expectant mothers and newborns.

Strong Start includes two strategies:

Fill out the optional Letter of Intent to Apply.

In an effort to connect applicants interested in partnering together and to address concerns from interested organizations that may not have enough pregnant women enrolled in Medicaid and CHIP to apply, CMS has created a platform for potential applicants who have submitted an LOI and want to participate. If organizations would like to use the platform, they will need to grant consent through the LOI form (or by an email to StrongStart@cms.hhs.gov for those who have already submitted an LOI) to have their information accessible in the platform and to gain access to the platform.

Many stakeholders have raised important issues since CMS announced the call for applications, and in order to address these issues CMS is revising the FOA and providing further clarifications regarding the initiative.

CMS will extend the application deadline to allow applicants the time they need to develop innovative models in response to the clarifications and revisions to the FOA. CMS would also like to note that Letters of Intent will not be required for Strong Start applications.

Therefore, those who did not submit Letters of Intent may also submit an application for Strong Start. We will provide further information about the revised timeline shortly.

Background

This initiative builds on decades of work by organizations like ACOG, the March of Dimes, the National Partnership for Women and Families, the Society for Maternal-Fetal Medicine, and Childbirth Connection, showing that elective deliveries before 39 weeks increase the risk of significant complications for both the mother and the baby, as well as long-term health problems. In addition, Strong Start’s goals and focus were identified with the help of experts at the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), ACF and HRSA.

Babies born prematurely are a growing public health problem with significant consequences for families and an estimated cost to society of at least $26 billion each year. Each year, this is more than half a million infants in the United States, a number that has grown by 36 percent over the last 20 years.

Infants born preterm are at greater risk for mortality and many endure a lifetime of developmental and health problems. In addition to enormous medical needs, these children often require early intervention services, special education and have conditions that impact their productivity as adults.

Additional Information on the Strong Start Initiative

Recent Updates:
06/12 – Important updates posted on Letter of Intent and application deadlines for Strong Start Medicaid Funding Opportunity

05/17 – Resources now available to support the Strong Start initiative
04/30 – Amended Strong Start Medicaid Funding Opportunity Announcement posted

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* The above information is adapted from materials provided by USA Department of Health and Human Services (HHS)
** More information at USA Department of Health and Human Services (HHS)

HHS

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