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Spreading Innovations in Health Care Delivery

This website, endorsed by Maryland’s Stakeholder Innovation Group, offers a glimpse at how many of Maryland’s health care providers and community organizations are working together to improve care delivery.

We urge you to use this site to share innovative programs and practices that improve the health of Maryland’s communities.

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Emergency Department Referrals for Pre-natal Care Services

  • What are the objectives of the program?

    Improved care coordination

  • Please provide a brief description of the program:

    Since 2009, through the work of B'more for Healthy Babies partners, the infant mortality rate has decreased by 38%, and the gap between black and white infants dying has fallen to two to one. However, there are still too many infants who are dying. Linking pregnant mothers to pre-natal care services is essential to preventing poor birth outcomes. Evidence-based resources such as home visiting, mental health and substance use treatment, food benefits, and safety planning when there is abuse, neglect, or interpersonal partner violence provides a an essential safety net for the patient. When these linkages don't occur, the risk of fetal or infant death increases five-fold. While there are several avenues for referral, not every pregnant woman who is qualified has a referral completed, resulting in a missed opportunity for support. It is estimated that approximately 15 to 30% of eligible pregnant women in Baltimore City are not connected. The Emergency Department is key in solving this issue. A previous pilot project at Mercy Medical Center demonstrated that within a 10-month period, 60% of the 861 pregnant women who had entered through the Emergency Department were unknown to the city's central care coordination unit. Of the 528 women who were contacted by the city's coordination, nearly 40% were successfully contacted with almost half agreeing to the city's care coordination. This project required, however a dedicated social worker to send the referrals. In October 2017, Mercy Medical Center, Chesapeake Regional Information System for our Patients (CRISP), Amerigroup, and the Baltimore City Health Department launched systems together to identify and connect eligible to prenatal care services in a streamlined manner. CRISP identifies eligible patients and matches the patient to the MCO panel to send to Healthcare Access Maryland (HCAM). HCAM and the patient's Managed Care organization (MCO) connect patients to community-based resources such as home visiting and substance use disorder treatment counseling.

  • Are incentive payments to health care providers part of the program?