Dr. Jennifer Howse, March of Dimes President, presented Greenstein with the award Wednesday, July 18, at the March of Dimes Opening General Session Awards. Greenstein gave an overview of successes from the Louisiana Birth Outcomes Initiative, which is designed to reduce the state's prematurity and infant mortality rates.
"One of my first experiences upon becoming DHH Secretary was receiving notice from the March of Dimes that Louisiana had an 'F' grade for birth outcomes," Greenstein said. "That was unacceptable, and I and other state health leaders knew we had to implement meaningful, transformative changes to give every baby the best possible chance to be born healthy and succeed in life. Today, I am proud to receive this award, and even prouder that our efforts have already led to better health for Louisiana moms, babies and families."
"As a result of Secretary Greenstein's leadership, Louisiana was the first state in our nation to step forward and formally accept the ASTHO/March of Dimes 8% challenge," Dr. Howse said. "The initiatives he has put into place in his state hold great promise for preventing premature birth, reducing NICU admissions and strengthening the health of Louisiana families."
One critical strategy to improve birth outcomes in Louisiana is the 39 Weeks Initiative, in which hospitals pledge to end elective, non-medically necessary deliveries before the mother has reached her 39th week of pregnancy, which medical professionals consider the optimal timeframe for a baby to grow and develop. In the past year, Greenstein and health department leadership secured pledges from all 58 birthing hospitals in the state to participate in this initiative.
These hospitals have already seen dramatic decreases in neonatal intensive care unit (NICU) admissions. An early pioneer of this policy, Woman's Hospital in Baton Rouge, the largest birthing hospital in Louisiana, has reported a 20 percent decrease in NICU admissions. Ochsner Hospital Foundation reported a 28 percent decrease. Data reported through February 2012 show that 14 of the hospitals participating in the 39 Weeks Initiative decreased elective deliveries by 60 to 80 percent.
Earlier this year, DHH enhanced the state's web-based vital records system, Louisiana Electronic Event Registration System (LEERS), to capture data on why babies are born before 39 weeks. With these data, DHH will have a real-time record of why preterm deliveries happen in Louisiana, which will help health officials identify patterns or risks and develop targeted interventions to address them.
Improved birth outcomes also are a key component of Bayou Health, the state's new model for delivering Medicaid health care services that was implemented statewide June 1. In Bayou Health, recipients enroll in one of five Health Plans, which are responsible for providing them with care management and coordinating their access to services. Medicaid covers 70 percent of births in Louisiana, and pregnant women are one of the recipient groups now enrolled in Bayou Health. DHH measures the Health Plans on 37 clinical health quality indicators, and many of these relate to pregnancy and birth outcomes to ensure better health for the mother and baby.
"Climbing up from 49th place in health outcomes is a long process that requires effort, commitment and collaboration at all levels," Greenstein said. "We know we won't get there overnight, but these first steps show we are moving in the right direction to deliver a healthier generation for Louisiana."
For more information on the Louisiana Birth Outcomes Initiative, visit www.boi.dhh.la.gov. More information about Bayou Health is available at www.MakingMedicaidBetter.com.
The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about DHH, visit http://www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow DHH's blog, Twitter account and Facebook.