Region IV and VI Infant Mortality Summit

1. Region IV and VI Infant Mortality Summit Paul E. Jarris MD MBA Association of Sate and Territorial Health Officials January 13, 2012

2. Thank You, HRSA!

3. Thank You!

4. Thank You !

5. Planning Committee • Danny Bender - MS • Susan Cooper – ASTHO Alumni (TN) • Bill Hacker – ASTHO Alumni (KY) • Suzanna Dooley - AR • Norm Hess - MOD • Lauren Ramos - AMCHP • Ellen Pliska - ASTHO • Kathy Vincent - ASTHO • Chris Dang - conference planner

6. ASTHO 2011 Presidential Challenge Improve birth outcomes by reducing infant mortality and prematurity in the United States Objectives: • Focus on improving birth outcomes as SHOs and state leadership teams work with state partners on health and community system changes • Create a unified message and strategy that builds on the best practices from around the nation • Develop clear measurements to evaluate targeted outreach, progress, and return on investment

7. S.M.A.R.T. Goals GOODNESS: Reduce preterm births by 8% by 2014 (based on 2009 level) FAIRNESS: Close the Racial Ethnic Gap

8. DRAFT STRATEGIES FOR A REGIONAL APPROACH TO REDUCING INFANT MORTALITY AND PREMATURITY • Implement state policy change to eliminate elective inductions and c sections prior to 39 weeks gestation • Hospital Policies • Payment – Medicaid (Waivers) • Individual, Provider Education • Improve access to care for all women o reproductive age including 17-P as clinically indicated • Develop and implement a regional campaign to address the following aspects of women’s health: • Life Course Health – preconception/pregnancy/inter-conception • Smoking cessation, especially for pregnant women • Chronic conditions – obesity and diabetes • Influenza immunizations for pregnant women • Safe Sleep

9. Scalable and Sustainable (be systematic!) • Policies • Community Development and Resources • Patient/Consumer Resources • Health Care Improvements • Data and Information to Drive Action • Payment and Incentives

10. Partner and Align! (The Stars Have!) • National Groups • Federal, State, Local and Regional Groups • Public and Private Groups • Employers • Insurers • Consumer groups

11. National Priorities PartnershipMaternity Action Team Roster • Childbirth Connection • Physician Consortium for Performance Improvement • American Academy of Family Physicians • American Board of Obstetrics and Gynecology • American College of Nurse-Midwives • American Congress of Obstetricians and Gynecologists • America’s Health Insurance Plans • Association of State and Territorial Health Officials • Pacific Business Group on Health • The Joint Commission • March of Dimes • Association of Women’s Health, Obstetric and Neonatal Nurses • Hospital Quality Alliance • Leapfrog • National Association of Medicaid Directors • National Association of Public Hospitals and Health Systems • National Committee for Quality Assurance • National Initiative for Children’s Healthcare Quality • National Partnership for Women and Families • Network for Regional Healthcare Improvement

12. Leapfrog Group • 2010: target for hospitals was a cesarean section and/or induction rate of less than 12% of the total number of non-medically indicated deliveries occurring between the 37th and 39th week of gestation. • 2011, Leapfrog lowered the target to 5% • Major Employers • FedEx, UPS • General Motors, Toyota • Qwest, Sprint Nextel, Verizon • Major insurers • Aetna • CIGNA • United Healthcare • WellPoint • Hospital Survey • MOD Toolkit

13. Next Steps for ASTHO with our Partners • Providing states with template for making the “economic impact argument” • Analysis of key components of successful Medicaid waivers • Coordinating with national partners • Focus on health disparities

14. Take Action! What will you do by Tuesday?