BCBSNE Funds Early Birth Study in Central Nebraska

Blue Cross and Blue Shield of Nebraska (BCBSNE) has awarded more than $200,000 for a new study that will focus on lowering the rate of early births in Lexington.

BCBSNE awarded its Fund for Quality and Efficient Health Care to the University of Nebraska Medical Center (UNMC) for the study to be conducted in central Nebraska. The study will begin in January 2015.

The BCBSNE Fund for Quality and Efficient Health Care provides financial support for new and innovative programs designed to improve care and reduce medical expenses.

 “This research is a real grassroots effort to address the health concerns of the communities and their providers,” said Dr. Mary Cramer, UNMC College of Nursing, who is the study’s principal investigator.

Pre-term birth, or the birth of a baby more than three weeks before the due date, is a rising concern in Nebraska. According to the March of Dimes, 1 in 9 births in the state is pre-term.

The study will target pregnant women in Lexington and Kearney, and researches the impact of combining regular interactions with a community health worker and health-related text messages.

“Pre-term birth is a serious issue,” said Dr. Joann Schaefer, vice president and chief medical officer, medical care and medical management at BCBSNE, “This innovative study gives moms-to-be access to the information they need to have the healthiest pregnancy possible.”

The mobile technology being used for the study is supplied by GoMo Health. Their Concierge Care condition-specific programs are used by health plans, hospitals and other health care organizations around the US to deploy patient engagement and education.

Dr. Cramer worked with health care providers and community leaders to develop the program, including the Central Nebraska Prenatal Community Advisory Board, Central Health Center, Lexington Regional Health Center and Arbor Health Plan, a Medicaid health plan. The Board is co-led by Stephen Lazoritz, M.D., Arbor Health Plan network medical director, and Ken Shaffer, M.D., UniNet medical director in Kearney.

 “Arbor Health Plan is excited about the implementation of this important project, and especially pleased to partner with the UNMC College of Nursing,” said Dr. Lazoritz. “Together we hope to learn innovative strategies that will improve the health and well-being of mothers and their babies.”

“Physicians have been looking for years for ways to decrease the rate of premature births,” said Dr. Shaffer. “This innovative community based research involving a community health worker and mobile technology working with our medical community may be one of the answers.”

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.