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Indiana Medicaid to stop paying for early elective births

INDIANAPOLIS – Health officials announced Monday the state Medicaid system will no longer pay for early elective births – a move meant to improve Indiana’s high infant-mortality rate and the overall health of newborns.

“Babies born too small or too early are at greater risk for death in their first year of life,” said State Health Commissioner Dr. William VanNess. “Babies’ brains develop significantly during the last two weeks of gestation, which is why it’s critically important to carry pregnancies full-term, unless medically necessary to induce sooner.

“This policy supports providing infants with the best chance to grow into healthy children.”

The Family and Social Services Administration – which oversees the low-income health program – said about 15 births a month might be affected.

Early elective births prior to 39 weeks gestation – such as planned inductions or C-sections – can still occur if the birth is eligible under a list of approved medical indications or occurs naturally.

In 2013 the Indiana State Department of Health formed the Indiana Perinatal Quality Improvement Collaborative to address ongoing issues related to perinatal care.

The IPQIC group recommended that Medicaid adopt a non-payment policy. FSSA’s Office of Medicaid Policy and Planning (OMPP) evaluated the request and agreed the policy change would help improve the health of mothers and babies.

The policy also aligns with initiatives by the March of Dimes, the American Congress of Obstetricians and Gynecologists, the Indiana Hospital Association, the state’s Medicaid managed care entities and many Indiana hospitals and their medical staffs, a news release said.

With this policy change, Indiana will become the fourth state to eliminate Medicaid payment for early elective deliveries. About half of all births in Indiana are covered by Medicaid.

The Indiana Hospital Association reports that early elective deliveries now make up less than 3 percent of deliveries in Indiana, compared to 11 percent in 2012.

“This action sends a strong and clear message that we will not tolerate dangerous and unnecessary early childbirths, which puts our newborns at risk and increases costs in Medicaid,” said Joe Moser, Indiana Medicaid Director. “We are proud to make this contribution to the state’s efforts to reduce infant mortality.”

Reducing infant mortality is the state’s top health priority. In 2011, the Indiana infant mortality rate was 7.7 deaths per 1,000 live births, making the Hoosier state 6th highest in the nation for infant mortality.