Anthem Blue Cross : Prenatal Program

Prenatal Program

PW_A115132

Prenatal Program

 
PROGRAM DESCRIPTION
The Prenatal Program provides members with a comprehensive program of prenatal care. The program is designed to identify members who are pregnant, encourage early and ongoing prenatal care, provide case management to members with high-risk pregnancies and increase members' access to perinatal information.  
Our goal is to help our members have healthy babies in the following ways:  

Increase the number of members identified as pregnant within 45 days of eligibility

Increase identification of potentially high-risk pregnancies

Increase access to appropriate prenatal care

Increase compliance with recommended schedule of prenatal visits

Increase linkages with community based resources

Increase access to prenatal education

 
Members enrolled in the Prenatal Program receive the following:  

Trimester mailings of perinatal information

Case management for high-risk pregnancies

Referral to community based resources as needed

Access to Prenatal Education classes

Baby gift for attendance at all prenatal appointments

 
The Prenatal Program helps the pregnant woman to understand and better manage her pregnancy to promote healthy birth outcomes. The program was developed specifically for state-sponsored members and focuses on their need for additional follow-up and support to better access health plan services. The member’s OB, PCP, and Anthem Blue Cross work together in partnership to meet the goals of the program.  
Identification of Participants  
Anthem Blue Cross identifies pregnant women in several ways. Primary Care and Obstetric Providers fax or call in a pregnancy notification. All members receive a reminder in their enrollment package to call if they are pregnant. All women between the ages of 16 and 50 who call the customer service number are provided information about the Prenatal Program.  
Program Components  
Prenatal Program
Participants receive an educational packet at each trimester. The packets include information on nutrition, warning signs, alcohol, tobacco and substance use, breastfeeding, immunizations, and other pregnancy related topics. The materials are easy-to-read and available in English, Spanish, and Vietnamese.  
Prenatal Gift
Participants who attend all of their prenatal appointments receive a baby gift. The participant must return a postcard with their provider signature to receive the gift. The gift contains: a diaper bag, one piece creeper, bib, baby comb, baby rattle, and immunization magnet.  
Case Management
Participants who are identified with one of the following high-risk indicators are referred to the Anthem Blue Cross Case Management Program for more intensive follow-up and support if needed: Participants who are identified with one of the following high-risk indicators are referred to the Anthem Blue Cross Case Management Program for more intensive follow-up and support if needed:  

Diabetes

Hypertension

Currently taking medication for another condition

Previous pre-term labor or pre-term delivery

Previous problem pregnancies

 
Each member opened for case management services is assigned a Case Manager. The Case Manager refers the participant to other programs as needed such as Sweet Success, genetic counseling, specialty care and CPSP. The Case Manager follows the participant throughout their pregnancy and delivery.  
Prenatal Education Classes
Anthem Blue Cross has contracted with several hospitals to provide prenatal classes in a variety of topics. Some of the classes participants may self-refer to are: early prenatal, childbirth education, breastfeeding, and baby care. Participants register by calling the Anthem Blue Cross customer service unit.  
Provider Education 
Providers receive information about the Prenatal Program in their Provider Operations Manual as well as during Provider Training Sessions. Informational packets are sent to targeted providers. The quarterly provider newsletter contains program updates as needed.  
 
 
WOMEN, INFANTS, AND CHILDREN (WIC) SUPPLEMENTAL NUTRITION PROGRAM
The California Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a supplemental food and nutrition education program. It serves low-income pregnant, breastfeeding, and postpartum women, and infants and young children who are at nutritional risk.  
The purpose of the WIC program is to prevent health problems and to improve the health of program participants during critical times of growth and development. It is unique among federally administered food assistance programs because it provides specific supplemental nutritious food and nutrition education to a specific target population as an adjunct to ongoing health care.  
To be eligible for WIC, an individual or family must have income at or below 185 percent of the federal poverty level. In addition, the person must reside in the local agency’s geographic service area and be at nutritional risk as determined by a health professional. Finally, the individual must be categorically eligible as a:  

Pregnant woman

Breastfeeding woman up to 1 year after childbirth

Postpartum woman up to 6 months after childbirth

Infant: 0 to 1 year of age

Child: 1 to 5 years of age

 
The WIC program provides services in all 58 counties through 82 local WIC agencies, of which 40 are local health jurisdictions and 42 are private, nonprofit agencies. In the aggregate, these local agencies operate more than 600 WIC clinics statewide.  
California operates the nation’s largest WIC program. It is 100 percent federally funded through the U.S. Department of Agriculture (USDA). In SFY 1995-96, the California WIC Program spent approximately $825,476,000. Of that amount, $666,791,000 was spent on food (this includes $184,000,000 received as manufacture rebates), and $158,685,000 spent on nutrition education, breastfeeding promotion and state and local agency program administration.  
Your physician can assist you with enrollment in the WIC program if your are eligible.  
 
 
WHY BREASTFEED?
Human milk is best for babies  

Breast milk is easy to digest and contains everything a healthy baby needs for the first months of life.

Breast milk has special factors that help babies grow.

Breast milk has protective agents that keep babies from getting sick.

Breastfeeding may help with brain and eye development.

 
Breastfed babies are healthier  

Babies who are only breastfed for at least 4 months are less likely to have ear infections.

Breastfed babies are less likely to have diarrhea.

Breastfed babies are less likely to get certain diseases such as diabetes and meningitis.

 
Breastfeeding helps mothers recover from labor and delivery  

Breastfeeding helps reduce blood loss after delivery.

Mothers who breastfeed for at least 3 months may lose more weight than bottle-feeding mothers.

 
Breastfeeding keeps women healthier  

Breastfeeding women are less likely to get breast and ovarian cancer.

Breastfeeding may reduce the risk of bone loss as women age.

 
Breastfeeding costs less  

Formula costs have increased 150 percent since 1980.

 
 

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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.