Select Health has a special interest in the health of babies and children in South Carolina. In 2008, with spontaneous preterm births increasing in the state, Select Health elected to develop a program that would reduce the number of preterm births for pregnant members with a history of spontaneous preterm birth. In the quest to develop this program, Select Health assembled a Maternal Fetal Subcommittee using the health plan’s participating Maternal Fetal Specialists to evaluate the available research and develop guidelines in the use of 17 alpha-hydroxyprogesterone caproate (17P).
Based on the analysis of available research and input from the plan’s Maternal Fetal Medicine Subcommittee, Select Health concluded that results strongly supported the use of 17P to reduce the risks of recurring preterm births for the subpopulation members at risk. Select Health was the first plan in South Carolina to offer 17P to its members. The program offers:
- Benefit coverage guidelines for 17P
- Physician awareness of advantages of 17P use
- Identification of high risk pregnant members
- Member awareness of the importance of early and consistent prenatal and postpartum care
- Collaboration with the Medical University of South Carolina’s department of Maternal Fetal Medicine
- Site visits to OB-GYN offices to review guidelines and encourage appropriate use of 17P
- In-home administration of 17P for members on bed rest or those residing in rural areas (who have difficulty with transportation)
Select Health has experienced a number of beneficial outcomes resulting from the use of 17P. When used according to protocol, 17P shows up to a 73 percent reduction in recurring preterm births in eligible members. Additionally, significantly lower rates of necrotizing enterocolitis, intraventricular hemorrhage and the need for supplemental oxygen are reported in infants born to mothers who received 17P.