Making strides in maternal health and beyond

As a result, employers may want to consider how the right mix of benefits, resources and support can help their employees find quality care, manage their health care costs and deliver a whole-person approach across their continuum of care. This approach may also help turn the tide on the country’s high maternal mortality rate, which has reached its highest level in 60 years.³ Helping close gaps in maternal health outcomes across different racial and ethnic groups may be another byproduct of this type of approach.⁴

There’s no one-size-fits-all maternal health journey. Plus, maternal health needs aren’t static: they may change throughout the various stages of that journey. That’s why it’s critical that employees have access to a convenient continuum of care for all the eventualities that may arise, from pre-conception to postpartum.

Employers can play a role in healthy pregnancies by ensuring that the employees in their workforce have access to quality care. That means a network with quality providers, including OB/GYN providers, who can help prepare them for pregnancy.

For instance, women with chronic conditions are at an increased risk of experiencing adverse pregnancy outcomes.⁵ That’s where primary care providers (PCPs) can come in and help women manage these conditions and guide them to any needed specialists.

"Members that have a primary care physician tend to have a lower total cost of care," says Stephanie Alberti, vice president of commercial medical products for UnitedHealthcare Employer & Individual. "And our research demonstrates members have a better experience because they’re able to navigate our very complex health care system a little bit easier."

Employers can also help boost the health of their employees by offering access to healthy lifestyle programs that incentivize them for participating in healthy behaviors, such as getting exercise and seeing a PCP. Getting healthy before getting pregnant can help increase the possibility of a healthy pregnancy.

Even still, research suggests that a sizeable portion of couples face challenges around becoming pregnant.

A positive pregnancy test signals the start of many new experiences for an employee. Even when a mom and baby appear healthy — and providers term the pregnancy “routine” — everything from the number of prenatal appointments to the prevalence of morning sickness may require more support from the insurer and the employer. 

Prenatal care: One in 10 babies covered by employer health plans is born prematurely, which results in worse health outcomes when compared to full-term infants, not to mention 12 times the cost.⁸

Adequate prenatal care can reduce the incidences of low birth weights, pre-term births and even death, as well as spot and treat maternal conditions such as anemia and gestational diabetes.⁹ This includes having access to a 24/7 nurse line, which some health plans offer, to help women traverse the unknowns of each trimester or having access to convenient care options. Prenatal and postpartum care can rack up a minimum of 15 appointments,¹⁰ which can interrupt their workday. Offering plans with virtual health options and digital tools such as remote monitoring technologies may help solve for some of those time stresses.

Virtual options may also be helpful for the 2.2M women of childbearing age who live in maternity care deserts — places where access to maternal health care is limited or absent altogether.¹¹

High-risk pregnancies: Sometimes, a visit with a provider or an ultrasound reveals abnormalities and suddenly an employee finds themselves in high-risk pregnancy territory. With a complicated pregnancy, navigating the health care system and knowing where to turn can become even more difficult for employees who find themselves needing to meet with an array of different providers and obtain different screenings and tests.

Ensuring employees have access to a network of providers who specialize in complex needs, as well as a health plan that helps cover those additional treatments, can provide them with the support they need during what can often be a stressful time.

Understanding that many high-risk pregnancies end up requiring bed rest, it’s important that employees also have access to more convenient or home-based care options. For example, when an eligible UnitedHealthcare member fills out a maternity support assessment on myuhc.com® and is identified as high risk for pre-term labor, that employee is connected to an OB Homecare RN who can provide weekly assessments and home-based care. 

Childbirth and delivery: Long before water breaks or contractions start, many employees have crafted a birth plan — a written outline of how they’d like their labor and delivery to proceed, starting with the site-of-care. Employers can support their employees by offering coverage for a variety of preferences, whether that’s home birth supported by a doula or a hospital birth supported by a staff of doctors and nurses.

Although many women may hope for a vaginal delivery, about 1 out of 3 of live births are Caesarean Section (C-Section) deliveries.¹³ C-Sections can be the safest options in certain situations, but they do have cost implications for both employers and employees. For instance, women who gave birth by caesarean spent an average of $26,280 more on health care than those who did not, and those with a vaginal delivery spent an average of $14,768 more compared to women who had not given birth.

When a birth plan goes off course, it can cause anxiety. UnitedHealthcare advocates can serve as a dependable resource when employees experience complications in the delivery room or if their newborn has complex issues and requires a stay in the neonatal intensive care unit (NICU).

Unknown costs can contribute to anxiety. Surest™, a UnitedHealthcare company, designed a health plan where members can see upfront prices in advance. Even better, lower prices are assigned to higher-value care based on quality, efficiency, and overall effectiveness. With this visibility, members can make informed decisions — and may choose differently, whether selecting a provider or specific site of care.

Plans that offer first-dollar coverage, or zero copays and out-of-pocket costs before coverage starts, may be another way to reduce some of the stress around maternal health care costs. And if unexpected bills do come, services like Naviguard® that negotiate out-of-network bills can offer additional benefits.

Reaching the finish line of pregnancy is a huge achievement, but it’s also the start of a new journey. This postpartum period can introduce a whole new set of challenges and health care needs for both the mother and the baby.

Employers can support their employees by offering a network of quality providers that can care for their employees’ growing families. Since breastfeeding is another choice many new mothers make, employers may want to provide plans that include coverage for the purchase of breast pumps at no cost to the member. Employees can also access resources on myuhc.com, including educational videos about breastfeeding, postpartum care and more.

During the postpartum period, many can experience the baby blues. Having behavioral health care options — or better yet, having an advocate directly connect you to behavioral health care support through a health plan that integrates medical and behavioral benefits — can result in better outcomes and lower costs over the long term.

And then, when an employee’s parental leave ends and they return to work, they will begin juggling both work and family responsibilities.

 "It can be tough to transition back to work after having a baby," says Dr. Rhonda Randall, chief medical officer for UnitedHealthcare Employer & Individual. "It’s critical for employers to be cognizant of the challenge and not only offer employees flexibility and understanding but a benefits package that has their family’s interest in mind and supports them along their maternal health care journey."