SC HealthViz Findings

Have you ever needed to obtain data quickly on the health of mothers and babies in SC? The SC BOI Data Team releases statewide reports at least twice a year to help track statewide progress on key maternal and infant health measures. This month’s report is a companion document to the newly released SC BOI interactive report online dashboard, which provides authorized hospital staff with important data to facilitate data-driven collaborative decisions to improve the clinical outcomes of mothers and babies in SC. The data in this report represents the linkage of UB-04, birth, and Medicaid recipient records.

Among the report's contents are:

• a summary of state-level aggregated information provided to hospitals via the dashboard, which provides maternal and newborn characteristics and quality measures that include several new characteristics including plurality; parity; newborn length of stay; newborn hospital charges; and maternal age, race, and residence as well as previously reported SC BOI outcomes; and
  
  
• statistical testing results that identify whether perinatal level or statewide newborn and maternal health quality measures are increasing or decreasing over time. 

Interested in reviewing additional data? Visit the newly released Statewide SC BOI dynamic dashboard that will allow you to (a) further explore these data by specific demographic characteristics and (b) connect data to quality improvement tips, resource information, maps, and outcome results for the new Alliance for Innovation on Maternal Health (AIM) initiative. 

Click here to get the PDF of the SC BOI Statewide Report.

In the 21^st Century, South Carolina has experienced the fastest Hispanic population growth among Southeastern states and the 3^rd fastest growth in the nation. Three of every 10 Hispanics in South Carolina lack health insurance.

Information about the geographic distribution, demographic and socioeconomic characteristics, and Hispanic/Latino origin of the Hispanic population in South Carolina can strengthen policy and programming efforts to increase health insurance coverage and improve health outcomes for Hispanic residents of the state.

These statistics and more can be found in our infographic.  

July 2016 marked the five-year anniversary of the SC Birth Outcomes Initiative (SC BOI), a collaboration of more than 100 stakeholders statewide focused on improving the health of all SC mothers and newborns. The Initiative has been a model for other states with SC’s unique public-private partnership leading the way with

• statewide expansion of CenteringPregnancy^® and Baby-Friendly Certification;
• Medicaid coverage of postpartum insertion of long-acting reversible contraceptives;
• payment reform for early elective deliveries;
• reimbursement of behavioral health screenings for pregnant and postpartum women; and
• clinician training through webinars and SimCOACH, the first mobile simulation laboratory in South Carolina.

SC BOI has helped improve maternal and child health outcomes with a

• 31% decrease in the Joint Commission’s early elective delivery measure,
• 58% decrease in non-medically indicated early elective inductions, and
• 9% decrease in elective primary and total C-Sections. 

The work of the SC BOI has been highlighted by National Public Radio, New York Times, and other national news outlets. In June of 2016, the South Carolina section of the American Congress of Obstetricians and Gynecologists won the national organization’s Council of District Chairs Service Award for their involvement in BOI’s innovations. Most recently, Dr. Amy Crockett, BOI’s clinical lead, won the ninth annual John P. McNulty Prize for the Liberty Fellowship project in October, 2016.

More good news about accomplishments at the 5-year mark are highlighted in the 2016 BOI Infographic.^† 

^† As SC Healthviz focuses on SC DHHS Medicaid data, results represent only infants with Medicaid. Similar trends were seen for all infants.

Screening, Brief Intervention, and Referral to Treatment (SBIRT), part of a larger intervention strategy by the SC Department of Health and Human Services (SCDHHS), is designed to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.¹ SBIRT targets those with nondependent substance use with effective intervention strategies that hopefully prevent the need for more extensive or specialized treatment.¹

^.In South Carolina, these services were expanded for pregnant women and those who have had a baby within the past year and who receive Medicaid after analysis by the USC Institute for Families in Society found that about in one in three SC female Medicaid recipients in 2010 and more than one in four in 2011 had an opiate prescription² at a time when US deaths from prescription painkiller overdoses among women had increased 400%.³

More than 9,000 women were screened in 2014.⁴ The health care of pregnant women who have Medicaid insurance in SC and who have an SBIRT screening shows generally higher scores than all Medicaid participants in SC and the US in important measures of care quality that include access to preventative/ambulatory care services and timely prenatal care.

To read more about South Carolina’s SBIRT Initiative and the findings among SC Medicaid enrollees, download the pdf infographic here.

Notes:

¹ Department of Health and Human Services Centers for Medicare & Medicaid Services. Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services. Retrieved from http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/SBIRT_Factsheet_ICN904084.pdf

² Lòpez-DeFede, A., Harris, T., Blanco-Silva, K., & Walker, D. (2012, Sept 12). Women of childbearing age and opioids: Preliminary data SC Medicaid Program. Retrieved from https://www.scdhhs.gov/sites/default/files/BOI%20Opiates_PreNatal%20Sept%2012_2012.pdf

³ Centers for Disease Control and Prevention. (2013, July). CDC Vitalsigns: Prescription Painkiller Overdoses. Retrieved from http://www.cdc.gov/vitalsigns/PrescriptionPainkillerOverdoses/index.html

⁴ Percentages represent data for state fiscal year 2014 (July 1, 2014 – June 30, 2015).

An annual report released today highlights how the South Carolina Birth Outcomes Initiative (SCBOI), a multi-stakeholder collaborative led by the South Carolina Department of Health and Human Services (SCDHHS) focused on improving birth outcomes, has reduced unwarranted early-elective inductions by 50 percent from 2011 to 2013 with 60 percent of all birthing hospitals in our state boasting a rate of zero percent for early elective inductions between 37 and 38 weeks.

The annual report, compiled by the University of South Carolina Institute for Families in Society, highlights several areas of SCBOI success.

“The Birth Outcomes Initiative is a wonderful example of leaders in the health community working together as a team,” said South Carolina Governor Nikki Haley. “Using these strategies allows us to make great strides in improving the health of moms and babies in South Carolina, ultimately driving down infant mortality and saving lives.”

“Early elective deliveries result in worse health outcomes for infants and higher health care costs,” said Christian Soura, director of SCDHHS. “Through the SCBOI, our state has been able to reduce these non-medically necessary inductions by 50 percent from 2011 to 2013, and we only expect this number to improve.”

“The statewide partnership aiming to reduce early inductions has really paid off,” said Thornton Kirby, president and CEO of the South Carolina Hospital Association. “We are ecstatic about the reduction rate, and SCHA looks forward to the ongoing collaboration with the Birth Outcomes Initiative to continue this trend with the best interest of moms and babies in mind.”

Read more about the work of the SC Birth Outcomes Initiative, which was featured in The Post and Courier, and get the Annual Report. You can also read the full text of the press release.

During the summer of 2014, The University of South Carolina, Institute for Families in Society, Division of Medicaid Policy Research conducted a retrospective study of opioid use among South Carolina female Medicaid recipients of reproductive age.

The Key Findings were as follows:

• The majority of female Medicaid patients of reproductive age were prescribed chronic short-acting opioid (SAO) therapies.  Anywhere between 4% and 26% of patients receiving chronic opioid therapy have an opioid use disorder, and among these patients, one in ten misuse opioids.[1] 
• Over 6,000 patients were prescribed hydrocodone-acetaminophen, and these women were not only more likely to visit more than one prescriber to receive their prescription, but were also most likely to be continuous users for a year.
• The potential maternal and child health risks associated with this misuse are significant, especially since approximately 14% of female patients ages 18-44 delivered a baby in both of these fiscal years and women of advanced maternal age, who are at greater risk of adverse pregnancy outcomes, were more likely to be prescribed.[2] 
• These data suggest the need for changes in service delivery that promote early identification of opioid-dependent women of reproductive age, which is key to improving both maternal and infant outcomes, as well as reducing overall cost to the state Medicaid agency resulting from potentially high ER utilization, neonatal intensive care unit costs, prescription monitoring, medical complications, and treatment.

To read more, click here.