Pregnancy Care Management is a free and voluntary program available to pregnant women who qualify for Medicaid Pregnant women, eligible for Medicaid, that meet certain conditions may qualify for services. Examples of conditions include having had a preterm baby, a chronic illness such as diabetes, or other concerns, such as wanting help to quit smoking. Care managers and prenatal care providers work together to help women achieve a healthy pregnancy.

Pregnancy Care Managers can help pregnant women by:

• Reviewing plan of care for a healthy pregnancy
• Helping patients overcome barriers to following recommended medical care
• Helping with services such as medical care, transportation, food, or stable housing
• Providing assistance in managing any medications
• Making follow-up appointments, including postpartum clinic visits
• Assisting with connections to Medicaid, Women, Infants, and Children (WIC), Family Planning, Childbirth Education Classes, Care Coordination for Children, and other community resources

During COVID, the Care Management for High-Risk Pregnancies program shifted away from seeing clients at the OB practice as we had done pre-COVID and limited home visits with clients.  In 2022, we pivoted back to seeing clients at the OB practices again and working more as we had done prior to COVID, which also included increased home visits when indicated. July 2022 marked the 1-year anniversary of partnering with the pre-paid health plans (Amerihealth, Healthy Blue, United Health, and Wellcare) with managed care. Although there continued to be challenges around electronic data transfer at this point, much progress has been made in forging partnerships with the PHPs, especially as it relates to the referral of members to the Care Management For High-Risk Pregnancies program. In March of 2023, our care managers on-boarded with the Healthy Opportunities Pilot (HOP) program to serve as HOP Care Managers for our clients to better assist with addressing social determinants of health needs. Discussions began and education was provided about the roll-out of Tailored Care Management with the tailored plans (our assigned tailored plan is Trillium).  Tailored plans were anticipated to begin in 2023 but did not actually “go live” until July 2024.