In 2022, to improve maternal health Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid implemented a Non-Medical Drivers of Health (NMDOH) and Prenatal/Postpartum Care (PPC) Performance Improvement Project, to focus on reducing health disparities, improving PPC and Low Birth Weight Rates (LBW).
By increasing utilization, members who use PPC services as intended have a decreased risk of maternal and fetal complications. As our Healthcare Effectiveness Data and Information Set (HEDIS) Hybrid results for prenatal and postpartum care demonstrate an opportunity to improve care, this impacts our members’ health, outcomes, and satisfaction with their providers.
Provider Opportunities
Notify eligible pregnant BCBSTX Medicaid members, who may be unaware, of the Value-Added Services (VAS) available:
- Free Infant Car Seat or Pack and Play Play-yard
- Prenatal Classes with an Incentive Diaper Bag
- Prenatal Incentive Gift Card
- Fresh & Healthy Food Support for Pregnant Members
- Postpartum Incentive Gift Card
- Breastfeeding Education through our Special Beginnings Program
- New Mom Welcome Home Kit
We want to ensure we address the following:
- Promote preventive care and services
- Address gaps in care
- Support our Quality Improvement Programs
- Engage members in their own care
Once a positive pregnancy diagnosis is confirmed, please refer them to BCBSTX Special Beginnings (SB) maternity program at:
Email: TXSBMedicaid@bcbstx.com Call: 1-888-421-7781
- Ensures timely prenatal care and additional resources
- STAR members can also be referred by the SB service coordinators, after initial assessment into the program and members interest in referral, to the NMDOH/PPC Performance Improvement Project ‘s collaborating partner, Any Baby Can (ABC)
- ABC provides prenatal resources for members who are first time moms, <28 weeks, enrolled in SB program, and extends postpartum care for two years post-delivery
Resources:
Value Added Services (VAS) offered to members can be found using our website at:
Special Beginnings enrollment/customer service line: 1-888-421-7781 Special Beginnings email: TXSBMedicaid@bcbstx.com
Reference:
For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:
Quality Improvement (QI) Toolkit and Tip Sheets. BCBSTX Preventive Care Guidelines (PCGs) Clinical Practice Guidelines (CPGs) Texas Health Steps (THSteps) for Medical Providers ImmTrac2