Louisiana Expands Access to 17P Progesterone Injections for At Risk Pregnant Women

September 04, 2015|12:14 p.m.| ASTHO Staff

Preterm birth is the leading cause of infant mortality in the United States, and synthetic injectable progesterone treatments like 17-alphahydroxyprogesterone (17P) can help women at risk for preterm birth maintain their pregnancies and deliver healthy babies. However, only 5 percent of Louisiana women who are eligible for 17P have been able to receive the drug. This is both a timing and a supply issue: 17P only works between the 16th and 20th weeks of pregnancy, by which point Medicaid managed care organizations often don’t yet have patients’ pregnancy histories (or women haven’t visited their physicians). In addition, even when women are identified in time, not all pharmacies will carry 17P.

The Louisiana Department of Health and Hospitals (LDHH) took several steps to circumvent these logistical and resource issues to reduce infant mortality in the state. In September 2014, LDHH linked its vital records and state Medicaid data to generate a weekly report of women with previous preterm births who were possibly eligible for 17P. This list is now automatically shared with Medicaid managed care plans, which are able to easily identify and reach out to these women when they register with their plans.

LDHH and Medicaid also created the nation’s first injectable progesterone pay-for-performance measure for Medicaid managed care plans, with $2.5 million at stake. The measure aims to increase the amount of eligible women receiving 17P from 5 percent to 20 percent, an increase of approximately 600 women. Plans could lose up to $250,000 if they do not meet this measure.

To incentivize clinical providers to carry and administer 17P, Louisiana is working on a state Medicaid plan amendment to increase the price of compounded 17P from $19 to $75. The state partnered with the Louisiana Hospital Association to educate clinical providers about these incentives.

Learn more about how Louisiana is reducing preterm births by reading the full story from ASTHO's "Have You Shared" story collection. Check out ASTHO’s Healthy Babies map to learn more about state-led initiatives to improve birth outcomes, and learn more about ASTHO’s work to reduce infant mortality on our Maternal and Child Health web page.