O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1

Babies, Businessand the Bottom Line

Fewer preterm births

Potential cost savings(in billions)

Preterm birthrate(% of live births)

231,000 fewer babies born preterm

$11.9 billion saved

Preterm Birth Reductions

*Preliminary dataSource: Preterm birth rates—National Center for Health Statistics, 2006 – 2012 final and 2013 preliminary natality dataFewer preterm births—calculated as the reduction in preterm birth rate since 2006 times the number of live births per year.Potential cost savings—based on estimated number of fewer preterm births and the average societal costs due to preterm birth from the Institute of Medicine, 2007.Prepared by March of Dimes Perinatal Data Center, June 2014.

Institute of Medicine Report, 2006Annual Societal Economic Costs Associated with Preterm Birth, US 2005

Preterm is less than 37 completed weeks gestation.Source: Institute of Medicine, 2007. Preterm Birth: Causes, Consequences, and Prevention. National Academy Press, Washington, D.C. Published and unpublished analysesPrepared by the March of Dimes Perinatal Data Center, 2007.

Total Costs = $26.2 billion annually

Immediate Short Term Medical Care for Preterm Infants$16.9 billion (65%)

Lost Household and Labor Market Productivity$5.7 billion (22%)

Maternal Delivery$1.9 billion (7%)

Special Education$1.1 billion (4%)

Early Intervention$611 million (2%)

Uncomplicated Premature/LBW All births$0

$20,000

$40,000

$60,000

$4,389

$54,149

$11,413

More than 12 times as much

Costs per infant include all employer payments for newborn medical care during the first year of life. Source: Truven Health Analytics, Inc. Costs of Preterm Birth. Prepared for March of Dimes, 2013.

Average Expense to EmployerNewborn Care

Cost Drivers: Average Newborn Healthcare Utilization

Inpatient days Outpatient Visits Prescriptions Filled0

5

10

15

20

25

2.2

13.8

3.2

14.8

19.7

4.8

Uncomplicated Premature/Low Birthweight

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 6

•Every week in Mississippi more than 744 babies are born. Of these babies:

• 127 babies are born premature• 87 are born low birth weight

under 3 lbs. 1 oz.• 282 are born by cesarean section• 7 babies die before their first

birthdayEstimated cost to be around $330,000,000 ( 6604 babies x $50,000 average cost)

our challenge

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 7

•To improve the health of babies by preventing birth defects, premature birth and infant mortality by:

our purpose

funding research

providing education to help moms and health

care professionals

supporting families with direct care and support

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 8

David J. Dzielak Ph.D.

MASI 8 t h Annual Winter Conference

February 26, 2015

O f f i c e o f t h e G o v e r n o r | M i s s i s s i p p i D i v i s i o n o f M e d i c a i d

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 9

Mississippi Division of Medicaid

The Mississippi Division of Medicaid has over 900 employees located throughout one central office, 30 regional offices and over 90 outstations. We are charged with facilitating the Medicaid program for the state of Mississippi.

Mission: The Mississippi Division of Medicaid responsibly provides access to quality health coverage for vulnerable Mississippians.

Values: We are committed to accomplishing our mission by conducting operations with…

Accountability * Consistency * Respect

* * *

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History of Medicaid• 1965 - Medicaid was created as part of the Social Security

Amendments of 1965, to provide health coverage for certain eligible, low income populations.

• 1969 - Medicaid was enacted by the Mississippi State Legislature

All 50 states, the District of Columbia, and five territories participate in the voluntary matching program.

Medicaid Overview• Federal Medical Assistance Percentage (FMAP)

Lowest match 50%, MS has highest match at 73.58%

• Eligibility determined by income and SSI status

• Based on the Federal Poverty Level (FPL)

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 1

Family Size 100% 133% 138% 143% 194% 209%

1 11,770 16,248 16,243 17,424 23,424 25,188

2 15,930 21,984 21,983 23,580 31,704 34,092

3 20,090 27,732 27,724 29,748 39,984 43,008

4 24,250 33,468 33,465 35,892 48,264 51,900

2015 Federal Poverty Level Guidelines

Who is Enrolled?

54.7% = Children

6.6% = Low Income Parents/Caretakers

17.6% = Disabled (Supplemental Security Income)

11.1% = Dually eligible

3.0% = Family Planning

1.9% = Pregnant Women

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 2

744,668Medicaid beneficiaries

50,191CHIP beneficiaries

794,859Total enrollment

As of January 31, 2015

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 3

Premature Birth in the U.S.• 1 in 9 babies born premature (before 37

weeks)• Leading cause of infant mortality• Leading cause of long term childhood

disabilities

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 4

By Definition

• Normal duration of pregnancy is 39-40 weeks• Preterm delivery – pregnancy duration of less

than 37 weeks• Low birth weight < 2,500 g. or 5.5 lbs. (range is

2,000 – 2,500 g or 4.4 -5.5 lbs.)• Very low birth weight < 1,999 g or 4.3 lbs. (range

is 1,500 – 1,999 g or 3.3 - 4.3 lbs.)• Extremely low birth weight < 1,499 g or 3.3 lbs.

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 5

Why Does This Matter ?

• Significant development of the brain in last six weeks of pregnancy

• Babies born before 39 weeks have an increased risk of learning disabilities and behavioral problems

• More likely to have breathing and swallowing problems.

• More likely to have apnea and SIDS

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 6

Interesting Statistics

• In 2013 Medicaid funded 60% of the deliveries in Mississippi

• 26.3 % of those were preterm deliveries • Of the preterm deliveries 42% were admitted

to the NICU. • Cost of preterm delivery for Medicaid in 2013

was $56 million

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US MS MS Medicaid0

5

10

15

20

25

30

11%

17%

26.3%

Percentage of Babies Born Premature

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Risk Factors for Preterm Delivery

• Race – African-American babies are 2X more likely to be low or very low birth weight

• Age - < 15 or > 40 increased risk• Multiple births – twins 2X more likely to be low

or very low birth weight• Maternal Health – drugs, alcohol, and cigarette

smoking during pregnancy• Socioeconomic status

O F F I C E O F T H E G O V E R N O R | M I S S I S S I P P I D I V I S I O N O F M E D I C A I D 1 9

What Causes Preterm Delivery?

• Genetic patterns • Low grade undiagnosed infections• Environmental factors• Physiologic signals to begin labor• Placental dysfunction• Structural changes in the uterus• Socio-demographic factors

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More Research is Needed

March of Dimes is very active in this arena

Learn more at prematurityreseach.org

Support Prematurity Research Centers

Enhance Your Employees’ Health

Join Community EventsBecome a CauseMarketing Partner

Care for momsin our community

Invest In Healthy Babies