Maternity/NICU Care
At every step of a maternity journey, individualized support delivers the best outcomes
Only ProgenyHealth brings personalized maternity case management, NICU utilization and case management, and NICU payment integrity – all under one roof.
Inadequate care comes with a cost
25%
of all U.S. women start care late in pregnancy or do not receive the
recommended number of prenatal visits.1
47%
increase in costs for severe maternal morbidities in Medicaid populations.2
37%
increase in costs for severe maternal morbidities in Commercial populations.2
1. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries
2. https://pubmed.ncbi.nlm.nih.gov/31655962/
We solve the maternity challenges health plans face everyday.
Early Identification
Every day in a pregnancy can matter. Identifying and
addressing risks as early as possible is vital to success. If you rely on incomplete histories and lagging claims data, you may struggle to identify pregnancies early enough to impact outcomes. Our platform identifies risks early to help prevent preterm births, NICU stays, and complications during and after delivery.
Ongoing Engagement
Missed connections mean missed interventions.
Plans often struggle to maintain consistent
engagement across critical touchpoints to ensure
prenatal and postpartum care. We engage your
members throughout their pregnancy journey to
improve outcomes while optimizing maternal and
infant care economics.
Staffing & Resources
Health plans are challenged to meet the needs of
their pregnant population. As an integral extension
of your Utilization and Case Management teams, we
deliver unparalleled value in Maternity and NICU Care Management and NICU payment integrity.
Blind Spots
Non-clinical social drivers and access barriers to care continue to be costly blind spots for health plans. Our maternity case managers proactively identify, address, and solve these gaps to reduce their impact on maternal and infant health outcomes.
We’re transforming healthcare for women, infants, and their families with our wholly integrated solution
Our team works together to build an uninterrupted continuum of care from prenatal health to one year of life.
Maternity & NICU Case Management
Maternity Case Management – ProgenyHealth Case Managers work with families and collaborate with their physicians through the milestones of maternal care – from pregnancy and delivery to postpartum and parenting.
NICU Case Management – In the event of a NICU admission, our NICU Case Managers support discharge planning, screen for postpartum depression, and provide education and clinical support. Importantly, they also identify and solve Social Determinants of Health.
NICU Utilization Management
Proprietary Data Platform – Baby Trax® leverages over 20 years of clinical intelligence to support clinical decisions and help deliver better outcomes.
Optimizing Quality Outcomes – ProgenyHealth offers industry-leading NICU expertise to drive quality outcomes and ensure appropriate lengths of stay and levels of care to reduce inpatient costs, physician fees, emergency visits, and unnecessary readmissions.
NICU Payment Validation & Assurance
Maximizing Value – When there is a NICU stay, we ensure that your billing matches what was authorized to drive maximum savings with our Payment Validation and Assurance service. We review every NICU claim against clinical authorizations, identify variances between approved days and levels of care, and confirm codes that may impact reimbursement.
Accurate Coding – ProgenyHealth identifies NICU billing inaccuracies, analyzes coding, and reduces waste in the payment process.
A proven partner for healthier outcomes
Our wholly integrated, tech-enabled solution builds a network of support with plans, physicians, and families for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life.
From the very beginning, we unite early health risk assessment data with self-directed digital tools and dedicated case managers who work tirelessly to connect at-risk moms-to-be with the resources, care, and support they need for a healthier, full-term delivery.
We ensure healthier outcomes—and lower total costs— across an entire at-risk population by promoting predictable, equitable, and standardized high quality care journeys.
In so doing, we help overcome systemic barriers to support healthier pregnancies and healthier starts to life for babies, one family at a time.
Discover how we standardize care delivery, improve outcomes, optimize costs, and unite plans, physicians, and families.
Visit progenyhealth.com or call us at
610-832-2001 ext. 227