Monday, September 15, 2008

United Healthcare making the first move{A450D53C-1854-


MINNEAPOLIS, Sep 10, 2008 (BUSINESS WIRE) -- UnitedHealthcare is launching
an effort to help physicians in its network reduce neonatal intensive care
unit admissions by sharing data highlighting the increased risk of neonatal
complications for babies delivered by scheduled C-sections.
The data, based on review of claims data for mothers and their newborns,
showed that 48 percent of newborns admitted to the neonatal intensive care
unit (NICU) were from scheduled -- many before 39 weeks' gestation --
admissions for delivery, a practice that is discouraged by the American
College of Obstetricians and Gynecologists (ACOG).
Medical research[1][2][3][4] shows the greatest growth in the rate of
C-sections is among women and their attending physicians who are opting for
elective procedures, many before 39 weeks' gestation. Also, a growing body
of recent research[5] reveals that newborns delivered prior to 39 weeks are
two-times more likely to end up in the NICU than babies born at 39 to 42
In a recent pilot study in a market in the Southwest, UnitedHealthcare
reviewed mother and newborn records and physician and hospital processes
based on ACOG guidelines and identified a variation in NICU admission rates.
After sharing its findings, physicians and hospitals in the pilot altered
practice patterns and realized a 46-percent decrease in NICU admissions in
the first three months -- a decline that has held stable for the subsequent
five quarters.
UnitedHealthcare is releasing reports and communications based on this model
to physician groups and hospitals nationwide. While adherence to
evidence-based guidelines around maternity care varies across the country,
several hospitals have established delivery protocols based on ACOG
guidelines and review processes to ensure adherence or required approval by
a review committee. Upon review, UnitedHealthcare observed that NICU
admission rates for these hospitals have typically been lower.
"Reducing the overall number of elective caesarean sections would
significantly decrease health risks for mothers and their newborns," said
Tina Groat, M.D., national medical director of Women's Health for
UnitedHealthcare, a UnitedHealth Group
: unitedhealth group inc com
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UNH <> 29.61,
-0.35, -1.2%) company. "Following our work with select physicians and
hospitals we have seen a marked reduction in NICU admissions, and we are
confident that these evidence-based methods can make a positive impact in
further reducing NICU admissions nationwide. Also, by enhancing our efforts
to educate expectant mothers, we have the opportunity to make a positive
impact in the care mothers and their children receive."
In addition, UnitedHealthcare is expanding its Healthy Pregnancy Owner's
Manual to help educate more expectant women about elective deliveries,
including risks to mothers and their babies for elective C-sections prior to
39 weeks' gestation. Available at, the Healthy
Pregnancy Owner's Manual provides expectant parents with access to important
information on scheduling delivery, and key things to consider about
elective deliveries such as:
-- waiting until 39 weeks helps ensure a baby's lungs are fully developed;
-- babies born before 39 weeks can be at increased risk for respiratory
problems and other conditions that might require special care;
-- women who have labor induced are more likely to need a C-section or
experience other labor complications.
Currently, more than 1.2 million C-sections are performed annually in the
United States -- often at an increased risk to newborns -- at a cost of more
than $14.6 billion per year, according to the federal Agency for Healthcare
Research and Quality (AHRQ). While some women may need medical intervention
as a result of fetal distress and other medical issues, more than half of
all C-sections are medically unnecessary, according to the AHRQ.
About UnitedHealthcare
UnitedHealthcare ( provides a full spectrum of
consumer-oriented health benefit plans and services to individuals, public
sector employers and businesses of all sizes, including more than half of
the Fortune 100 companies. The company organizes access to quality,
affordable health care services on behalf of more than 25 million individual
consumers, contracting directly with more than 560,000 physicians and care
professionals and 4,800 hospitals to offer them broad, convenient access to
services nationwide. UnitedHealthcare is one of the businesses of
UnitedHealth Group (UNH <>: unitedhealth
group inc com
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Sponsored by:
UNH <> 29.61,
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1 Reis RA, Gerbie AB, Gerbie MV. Reducing hazards to the newborn during
cesarean section. Surg Gynecol Obstet 1970;130:124-6.
2 V Zanardo, AK Simbi, M Franzoi, G Solda`, A Salvadori and D Trevisanuto.
Neonatal respiratory morbidity risk and mode of delivery at term: influence
of timing of elective caesarean delivery. Acta Paediatr 93:643-647, 2004.
3 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S,
Munson ML. Births: Final Data for 2005. National Vital Statistics Reports,
Vol. 56, No. 6, December 5, 2007, pp.20-21.
4 Laye MR, Dellinger EH. Timing of scheduled cesarean delivery in patients
on a teaching versus private service: Adherence to American College of
Obstetricians and Gynecologists guidelines and neonatal outcomes. Am J
Obstet Gynecol. 2006 Jun 12, 195, 577--84.
5 Gouyon JB, Ribakovsky C, Ferdynus C, et al. Severe respiratory disorders
in term neonates. Paediatric and Perinatal Epidemiology 2008; 22 (1): 22--30

SOURCE: UnitedHealthcare

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