Milwaukee has one of the highest infant mortality rates in the nation. So, when officials at Children’s Community Health Plan learned that a certain drug therapy known as 17P was making a difference in lowering premature births, they decided to investigate the therapy further.
Under the direction of Mark Rakowski, CCHP staff performed literature reviews, investigated evidence and communicated with patients and doctors about research showing that the drug therapy 17Alpha Hydroxprogesterone Caproate (17P) was effectively used to treat pregnant women at high risk for going into early labor.
“Premature births are the No. 1 driver of infant mortality in Milwaukee,” explains Rakowski, executive director of CCHP, a nonprofit health maintenance organization (HMO) that serves patients covered by BadgerCare, Wisconsin’s health plan for low-income families. The HMO is owned and managed by Children’s Hospital and Health System.
Focusing on efforts to reduce infant mortality by lowering the incidence of preterm labor was a natural path for the HMO to pursue, Rakowski says.
“Premature babies are at risk for developmental, physical and behavioral issues that may be life-long for the baby,” explains Rakowski.
The staff found that 17P was not a commonly used treatment and therefore not covered by most insurance plans or the state’s Medicaid program. Still, based on the research, Rakowski concluded that covering the treatment would improve the chance that more babies would be born at full term. The staff contacted physicians and let them know that the CCHP would cover the cost of the treatment for patients who qualified.
Since then, the treatment not only has served to improve patient outcomes, it has saved the HMO money because fewer premature births resulted in fewer newborns requiring long and expensive stays in hospital neonatal intensive care units.
“CCHP is the only health plan in Wisconsin to cover this low-cost therapy that runs around $200 per pregnancy, but represents tens of thousands of dollars of savings” says Gerry Steele, a spokeswoman for Children’s Hospital and Health System, who nominated Rakowski as a Health Care Hero for making advancements in health care.
