united states public health service recommends W r i t i n g

I need to have these two paragraphs combined into one (although they are very similar). they need to make sense, have a good rationale.

Medicaid: The 3 indicators are C-sections, Preterm birth, and NAS births

Specialty: Preterm birth, Prenatal care, and ART adherence

These are the specific instructions given

Topic:

Clearly state the PIP topic. Explain how the topic was selected, addressing the following required criteria:

1.Was selected following collection and analysis of data. (Critical Element)

• Provide plan-specific data and analysis to support the selection of the topic.
• If no plan-specific data were available, provide rationale for why the data were not included.

2. Has the potential to affect member health, functional status, or satisfaction.

• The narrative should explain how the PIP topic has the potential to affect member health, functional status, or satisfaction.
• The link between the topic and outcomes of care should be explained.

MMA:

The Plan is committed to ensuring optimal health outcomes for its members. Pregnant members are offered OB Case Management services to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child – C-Sections, preterm births, and NAS.

C-Sections – The federal government has set a goal of lowering the national C-section rate to 23.9 percent. Higher rates indicate there are probably women undergoing surgeries that are not medically necessary. Florida rates exceed the national goal; in the case of one Florida hospital, the C-Section rate was 68 percent.

Preterm Births – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.

NAS Births – Infants with NAS have prolonged hospital stays, experience serious medical complications, and place a tremendous strain on service systems. In Florida, sixty-two percent (62%) of babies born with NAS are covered by Medicaid.

NAS is associated with numerous central nervous system, gastrointestinal, as well as metabolic, vasomotor, and respiratory signs and symptoms, including high-pitched crying, seizures, sleep problems, poor feeding, diarrhea, poor weight gain, fever, nasal stuffiness, and rapid breathing.

Withdrawal signs will develop in 55% to 94% of newborns exposed to opioids in utero.

In Florida, NAS has increased from 592 (of 231,417) live births in 2008 to 1,411 (of 213,237) live births in 2011. During this time, racial/ethnic disparities existed such that NAS rates were substantially higher among non-Hispanic White infants than among non-Hispanic Black and Hispanic infants.

The number of hospital discharges for newborns diagnosed with NAS has increased 10-fold in Florida since 1995, far exceeding the 3-fold increase observed nationally. Notably, reporting of NAS varies by hospital because there is no statewide standardization for the diagnosis and reporting of substance exposed newborns. Therefore, statewide NAS data are likely underreported.

Sources:

oFlorida Health:

http://health.wusf.usf.edu/post/c-section-rates-ex…

Specialty:

The Plan is committed to ensuring optimal health outcomes for its members. Pregnant members are offered OB Case Management services, along with Care Coordination, to support and assist them throughout pregnancy and during the first months of a child’s life. As such, the Plan has committed to addressing three potential areas that have a significant impact on both mother and child –preterm deliveries, prenatal care, and ART adherence.

According to the March of Dimes, there are an estimated 120,000 to 160,000 women in the United States who have been infected with HIV. About 6,000 to 7,000 of women infected with HIV give birth annually. Since the beginning of the HIV/AIDS epidemic, approximately 15,000 children in the United States have been infected with HIV and 3,000 children have died. About 90% of those were infected with the virus during pregnancy or birth.

Preterm Delivery – Infants born before completing 37 weeks of gestation are classified as preterm births. These infants are at greater risk of health and developmental problems including increased risk of death before their first birthday.

Prenatal Care – A multi-care approach is the most effective way for pregnant women with HIV infection to have a healthy pregnancy and delivery. This approach will address the medical, psychological, and social challenges of pregnancy with HIV. A pregnant woman with HIV may also benefit from assistance with housing, food, child care, counseling support for herself and her partner. Substance abuse treatment and lifestyle counseling should be offered if needed.

Unless a complication should arise, there is no need to increase the number of prenatal visits. Special counseling about a healthy diet with attention given to preventing iron or vitamin deficiencies and weight loss as well as special interventions for sexually transmitted diseases or other infections (such as malaria, urinary tract infections, tuberculosis or respiratory infections) should be part of the prenatal care of HIV infected women.

ART Adherence – According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a 2% or less chance.

The United States Public Health Service recommends that HIV-infected pregnant women be offered a combination treatment with HIV-fighting drugs to help protect her health and to help prevent the infection from passing to the unborn baby.

Treatment during pregnancy has two goals: 1) to protect the expectant mother’s health, and 2) to help prevent passing HIV to the fetus. ART’s decrease the amount of HIV in the body thereby reducing the chance of transmission.

Sources:

oHIV and AIDS During Pregnancy:http://americanpregnancy.org/pregnancy-complicatio…

oHIV and Pregnancy: