Supporting Breastfeeding Mothers: The Anthem Medicaid Experience

Anthem Medicaid views the promotion of breastfeeding as an extremely worthwhile endeavor given the well-publicized potential health benefits. Many of our enrollees lead very complex lives. Therefore, impacting the health and well-being of members can be challenging. At Anthem, we utilize Community Resource Coordinators, our prenatal program Future Moms, and member incentives to promote prenatal care and breastfeeding among our Medicaid members. We engage and educate our network providers on the availability of support services so they may encourage the use of such services among their patients, our members.

Once a newly enrolled pregnant woman is identified, we automatically enroll her in our Future Moms prenatal program. Expectant mothers are engaged as early as possible in their pregnancy and educated on prenatal care, breastfeeding, and related topics. All members are sent hardcopy educational materials (Fig. 1), as well as information on the 24/7 toll-free line for access to nurse coaches and lactation consultants around the clock. Figure 1 shows an example of one of our educational mailings sent to our members on enrollment. Engagement continues throughout the pregnancy and postpartum/neonatal period so there is never a question that support is available.

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FIG. 1.

Example of an educational mailing to members in support of breastfeeding.

Our goal at Anthem is to provide access to and encourage quality health care for our members. We understand many of our members cannot focus on their health care needs until basic and social needs are met. Our programs provide support for all aspects of our members' lives to help meet these needs and to reduce stressors. With reduced stress, it is the hope that members will be more likely to initiate breastfeeding and more likely to continue breastfeeding. Through Anthem Medicaid's prenatal program, members' healthcare needs and resources are assessed, and they are offered lifestyle management support. Based on risk factors and needs, referrals are made to, and services coordinated for, such community resources as the Women, Infants and Children (WIC) program and La Leche League. Nutritional counseling is also offered to support the overall health of mothers and their babies. Members are screened for predelivery and postpartum depression and offered referrals as indicated. Postdelivery follow-up is provided, including breastfeeding support. In-home care for mothers and babies is coordinated and provided as necessary. Members are reminded of the availability of nurse coaches and lactation consultants 24/7 throughout the prenatal and postpartum/newborn periods.

In addition to our Future Moms outreach efforts, Anthem Medicaid utilizes Community Resource Coordinators—Anthem representatives on the ground in our communities—for further outreach to our members. These Coordinators educate members on covered benefits including health education classes and breastpump purchases and rentals (per state Medicaid guidelines). They enroll members in childbirth education and breastfeeding support classes and arrange transportation to provider visits and health education classes. Anthem Coordinators connect members to community-based home visitation programs and coordinate home health services for high-risk pregnant members. Like the Future Moms staff, Community Resource Coordinators refer members to community-based resources such as WIC and La Leche League. Anthem also hosts community baby showers to bring our members together and provide support. In addition, Anthem supports community-based breastfeeding coalitions, sponsors and attends prenatal and breastfeeding conferences, and supports development of state breastfeeding policies and legislation.

In some states, Anthem offers member incentives to promote appropriate prenatal, postpartum, and well-child care. Appropriate and timely care optimizes the opportunity for member engagement by the provider for education about various health issues, including the benefits of breastfeeding. One example of such an incentive is the opportunity for members to earn gift cards for preventative, prenatal, postpartum, and well-child visits.

Although many of Anthem's programs are member-focused, Anthem does engage providers to promote quality prenatal care and breastfeeding. Anthem disseminates current practice guidelines, including those of the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics. Anthem educates providers regarding opportunities for group prenatal care, breastfeeding support through Anthem and the community, and Medicaid benefits. This allows obstetric providers to help to promote available services. Through pay for performance reimbursement arrangements, providers are given incentives to encourage early prenatal care and timely postpartum follow-up care, as early and appropriate care allows engagement of the member for breastfeeding education and support.

Just as Anthem encourages and supports breastfeeding among its Medicaid members, Anthem is also a strong supporter of breastfeeding among its associates. Anthem associates are provided comfortable, private, designated rooms for breastfeeding and pumping and free lactation services. Discounts on the purchase of breast pumps are also available to Anthem associates who breastfeed. In further support, Anthem associates are provided a Mothers at Work kit that contains an interactive CD-ROM with step-by-step breastfeeding instructions, a breastfeeding book that outlines the breastfeeding process, and other products including a diary and milk collection and freezer storage bags.

Anthem fully recognizes the health benefits of breastfeeding and is committed to the promotion and support of breastfeeding among our Medicaid members and associates. Through support of expectant and new mothers, we strive to improve the health and quality of the lives of our members and their babies.