Women's Health Programs

Providing care across the spectrum

Our Women’s Health Programs can help manage the increasing costs related to complexities of pregnancy and childbirth. Services are designed to meet women’s health needs — from guidance and assistance with infertility, to support before, during and after pregnancy, to caring for fragile newborns.

OptumTM provides specialized solutions for the health needs of women. Our Women’s Health services include maternity, infertility and neonatal programs.

Maternity Programs

Preterm birth rate in the United States has increased more than 20 percent since 1990. In 2005, preterm births cost the United States more than $26.2 billion in medical and educational costs and lost productivity. Average first year medical costs were about 10 times greater for preterm than for term infants1.

Our Healthy Pregnancy and Maternity Support Programs provide tools, resources and experienced personal support to help women make healthy pregnancy choices and reduce costs associated with preterm birth.

Both programs work closely with expectant mothers to identify potentially high-risk pregnancies. As high-risk pregnancy factors can pre-exist or develop during the pregnancy, our nurses continue support throughout the pregnancy. Nurses are available after delivery for moms that need further support or questions answered.

Our Maternity Programs include:

Healthy Pregnancy
This program provides an over-the-phone pregnancy assessment with a care coordinator to review the individual’s health, lifestyle and other factors that may affect the pregnancy. If it is determined that a high-risk pregnancy may exist, the individual is connected with a nurse who provides support throughout the pregnancy.

Maternity Support
This program provides support for each individual before, during and after pregnancy. Our dedicated maternity nurses offer decision support, education and answers for expectant families. Our program also offers phone consultations that focus on wellness and screen for health risks. The consultations provide people with a comprehensive end-to-end maternity experience.

Infertility Programs

Infertility treatments are largely responsible for the significant increase in multiples and Neonatal Intensive Care Unit (NICU) costs. One in ten couples of childbearing age seek medical help for infertility2, and of those seeking treatment, more than 50 percent pursue in vitro fertilization and super-ovulation, both of which have significant risks of multiples.

Our Infertility Programs include:

Reproductive Resource Services
Specialized nurse consultants offer education and guidance throughout the treatment process. They provide access to infertility treatment through our Centers of Excellence network of clinics. These identified clinics have the highest level of expertise and can provide detailed information to help people determine their best course of action for diagnosis and treatment.

Managed Infertility
This program is a comprehensive risk-bearing solution that provides guidance from a nurse specialist, pre-certification for the individual/family, claims processing and peer-to-peer consultations. This solution is designed to help individuals navigate the complicated and often stressful aspects of infertility services. In addition to intensive specialized clinical case management and a Center of Excellence network, your organization can eliminate the volatility of infertility spend for predictable and stable premiums.

Neonatal Program

Neonatal Resource Services (NRS) helps control and reduce neonatal care costs with effective case management, guiding people to the highest quality and most efficient facilities and appropriately monitoring the level of care provided.

Specialized nurses provide on-site and over-the-phone case management to help guide high-risk individuals to the best neonatal intensive care unit (NICU) providers. The program also manages NICU cases both inpatient and post-discharge to reduce costs and improve outcomes. A dedicated and well-equipped team of specialized NICU nurses, case managers, and full-time medical directors care help individuals best care for their fragile newborns.

Neonatal Resource Services is often integrated with a maternity programs to identify high-risk pregnancies prior to delivery. Once identified, an Optum case manager will help educate the expectant mother about their care options and benefits of delivering at a level II or III NICU facility.

The rising incidence of multiple births is a major factor in spending on neonatal care. 50 percent of twins and 90 percent of triplets are likely to deliver preterm and ultimately be admitted to the NICU.3 When offering an infertility program to individuals, Neonatal Resource Services should also be considered.

Sources:

 

1 More Babies Born Prematurely, New Report Shows, The March of Dimes Website, Accessed May 22, 2008. http://www.marchofdimes.com/peristats/whatsnew.aspx?id=20&dv=wn

2 2008 Merck Serono

 

3 Center for Health Statistics, final natality data