SC HealthViz Findings

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SC BOI Marks 5 Years of Achievements 

01/04/2017

Click here for the 2016 BOI Infographic (pdf)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.

SBIRT - Making A Difference for SC Moms and Babies 

01/15/2016

Click to download the SBIRT fact sheetScreening, 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).

Report Reflects Continued Success Story 

03/09/2015

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.A smiling, expectant African American mother

“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, including a feature in The Post and Courier, and get the Annual Report. You can also read the full text of the press release.

Opioid Use Among Female SC Medicaid Recipients 

Study looks at female recipients of reproductive age
08/18/2014

Photo of prescription medicine bottlesDuring 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.



[1] http://www.supportprop.org/educational/PROP_OpioidPrescribing.pdf

[2] Percentage derived from data pulled from Truven Health Advantages Suite V. 5.1 with claims processed through July, 2014.  Percentage represents female patients ages 18-44 with a delivery/total number of female patients ages 18-44. 

Dynamic Report Generator Added to Site 

08/17/2014

A new, dynamic report generator was added to the SC HealthViz site August, 2014. This new feature provides users the option to explore Medicaid claims data for fiscal years 2008-2014 by filtering along more than one parameter, such as exploring county-level data by plan type and a specific demographic (i.e., gender, age group, gender, qualifying category, and race).

Using the new interface, reports can be generated for Medicaid enrollment and for a number of primary benefits and services provided by the SC DHHS Medicaid agency. Reports for a single year and the state overall or a select county provide a snapshot with pie charts for all demographics; whereas, reports for multiple years, provide bar charts and line graphs. 

Screenshot of ring charts available for single year view


When multiple years and counties are selected, both stacked and grouped charts are generated. 

Screenshot showing chart options for multi-criteria query


Individual charts can be exported using the export feature, or the entire report can be printed. As new data are queried, the charts update along with the underlying data presented in the report table at the bottom of each page and in the hover text within the graphs. 

Screenshot of dashboard with print and export functions highlighted 

This new feature was used to generate the data needed to update the 2014 Quick Facts for both enrollment and benefits and services paid through June 30, 2014.    

SC Birth Outcomes Data Featured in Esri ARC-GIS Product Gallery 

Collaboration results in "Briefing Book"
08/08/2014

Pages from Esri Briefings Book

Recently, the Division of Medicaid Policy Research at the USC Institute for Families in Society collaborated with Esri to develop a “Briefing Book” application that features South Carolina Birth Outcomes Initiative data. The Briefing Book is a configuration of ArcGIS and a JavaScript application that allows users to view and create map-based briefings and reports with interactive content. The application can be deployed by local, state, and national governments; utilities, NGOs, as well as private industries; to create and deliver dynamic and interactive briefings and reports for executives, decision-makers, knowledge-workers, and constituents.

You can see the resulting product, as well as a Birth Outcomes Analysis template, also based on MPR's work on the ESRI site.

 

 

 

 

Mapping the Percentage of C-Sections in South Carolina 

04/01/2014

South Carolina Birth Outcomes Initiative at the South Carolina Department of Health and Human Services is partnering with the South Carolina Hospital Association, other state agencies, private providers, payors, consumers and advocacy groups in an effort to improve the health of moms and babies through the reduction of cesarean sections for first-time, low-risk mothers across the state. As this infographic shows, compared to some states, SC has a comparatively low rate of early scheduled deliveries, but there are still gains to be made

Nationally, there has been an increased focus on improving the quality and safety of perinatal care, which specifically addresses the increasing C-section rate across the country. On February 19, 2014, the American College of Obstetricians and the Society for Maternal-Fetal Medicine released new guidelines to reduce cesarean deliveries in first-time mothers. These guidelines suggest several potential approaches, including allowing women with low-risk pregnancies to spend more time in labor, to reduce the risk of having an unnecessary C-section and decrease the national cesarean rate.

About one-third of all births in the U.S. are done by C-section, and most of those are in first-time mothers. This is a 60 percent increase since the mid-1990s. The rapid increase in cesarean birth rates raises significant concern that cesarean delivery is overused without any significant improved maternal or newborn outcomes. The observed increase is likely to be multi-factorial and may be related to medical liability fears, increased use of labor inductions or patient/provider preference. Not only do C-sections add unnecessary costs into the health care system, the procedure can increase complications for the mother and raise risk during future pregnancies.

This map details the percentage of births with a C-Section by ZIP Code Tabulation Area (ZCTA) from Calendar Year 2010 to Calendar Year 2012. Areas shaded with the darker green color have a higher percentage of births with a C-Section than those with lighter green shading (medium percentage) or grey shading (low percentage). Areas with red horizontal lines represent low birthweight (LBW) hot spots, those with a significant clustering of high LBW.  

 

Click for a pdf of the map of Percent of Births with C-SectionsGet this map as a pdf

SC Medicaid Low Birth Weight Clusters 

05/27/2013

According to America’s Health Rankings (2013), 9.9% of South Carolina babies born in 2011 weighed less than 2,500 grams (5 pounds, 8 ounces).  The state ranks 47th nationally in percentage of low birth weight babies and received an "F" on last year’s March of Dimes Premature Birth Report Card. 

March of Dimes recognizes premature birth and fetal growth restriction as the two primary causes of low birth weight, which is associated with a number of newborn conditions, including respiratory distress syndrome, bleeding in the brain, patent ductus arteriosus, necrotizing enterocolitis, and retinopathy of prematurity.  Later in life, babies born with low birth weight may be more likely than babies born at normal weight to have high blood pressure, diabetes, and heart disease.

Download PDF

SC Medicaid Low Birth Weight Clusters, FY2011