How Self-funded Employers Can Support Maternal Health

Proactive intervention is key across healthcare. For maternal care, it’s especially critical. 

Currently, women in the United States suffer from serious gaps in maternal health coverage compared to women in other industrialized nations. Commonwealth Fund, a private research foundation, reported approximately 22 women died from childbirth-related causes for every 100,000 live births in the United States in 2022—far exceeding other high-income countries including, Sweden, Australia, Chile, France, Korea, and the U.K.

Self-funded employers are financially responsible for providing healthcare to employees. Both cost control and ensuring positive health outcomes are critical factors to consider, and it is essential to include maternal care when making these decisions.

Healthy pregnancies contribute to reduced medical costs, fewer complications, and improved employee well-being—and it all begins with taking preventive action.

The Role of Maternal Health in Self-Funded Plans

Pregnancy is one of the most significant healthcare events in a person’s life. It has a profound impact emotionally, physically, and financially. This impact can be compounded if complications arise, many of which require expensive interventions, such as hospitalization, specialist visits, or neonatal intensive care (NICU). Although essential for mother and baby, these services can also place a significant strain on self-funded plans.

The Cost of Preterm Birth

Premature births, defined as births before 37 weeks of gestation, are one of the most common and expensive complications. In 2023, approximately 343,000 babies born were premature. When this happens, there are severe health risks for the infant and increasingly high costs for parents and employers. 

While the cause of preterm labor varies, the World Health Organization notes a link between preterm births and chronic conditions such as diabetes and high blood pressure, as well as lack of access to adequate prenatal care, high levels of stress, and poor nutrition.   

With preterm births, newborns often require prolonged stays in the NICU. Research from the Health Care Cost Institute found that on average a NICU admission costs $71,158. Employers who provide health insurance bear a significant portion of these costs.

Beyond the upfront care costs, preterm birth can also result in:

• An increased chance of long-term health problems, including respiratory issues, developmental delays, and learning disabilities. These conditions lead to increased healthcare utilization and associated costs throughout a child’s life.
• Loss of workplace productivity due to necessary extended paternal leave and increased absences in the long run. Research from the Journal of Occupational and Environmental Medicine in 2021 found that parents of preterm infants had 41% more missed workdays compared to other employees.
• Increased anxiety, depression, and post-traumatic stress in parents, particularly during the infant’s time in intensive care. 

The Benefits of Healthy Pregnancies on Employee Well-being and Business Outcomes 

Healthy pregnancies are about more than reducing medical costs. They also contribute to the overall well-being and productivity of the workforce. When employees experience smooth pregnancies with minimal complications, they are likely to take fewer sick days, recover faster after childbirth, and return to work more quickly. Employee well-being and continuity are both crucial for maintaining business operations, particularly in small to mid-sized companies, where the absence of key employees can affect productivity. 

By supporting employees during their pregnancies, self-funded employers also cultivate a positive workplace culture and demonstrate their dedication to employee well-being and family life.

The Solution: A Maternity Management Program 

To adequately support expecting mothers, self-funded employers need a maternity management program that offers personalized support with the goal of reducing the risk of pregnancy-related complications.

Healthgram’s Maternity Management program goes beyond basic prenatal care and offers employees comprehensive support throughout the pregnancy journey, including:

• Personalized support. From the moment a pregnancy is detected, the system automatically enrolls the expectant mother in the program based on her medical history and risk factors. The support provided by program nurses is then customized to align with the mother’s specific circumstances. This personal touch helps address individual concerns and mitigates potential risks​.
• One-on-one nurse consultations. Throughout a pregnancy, mothers receive regular consultations with a dedicated nurse. These sessions are scheduled once per trimester as well as once post-delivery to provide necessary continuous support. Nurses use these sessions to assist mothers by addressing medical inquiries, explaining health plan coverage, and aiding in finding in-network providers. Direct access to knowledgeable healthcare professionals fosters a collaborative approach to managing health and well-being during pregnancy​.
• Monitoring and early intervention: Healthgram emphasizes the importance of early intervention, especially for maternity care. For example, if a mother notices unusual symptoms like high blood pressure, the nurse can provide guidance for immediate action, hopefully preventing serious complications.. Proactive care helps reduce risks and keeps mothers and babies healthy while controlling costs at the same time.
• Behavioral modification and lifestyle support: Healthy pregnancies require lifestyle modifications, such as adequate nutrition, staying active, and avoiding harmful behaviors such as smoking. Nurses in the Healthgram’s Maternity Management Program work with expectant mothers to promote positive changes in these areas, which can also improve long-term health outcomes for both mom and baby.
• Cost control. A notable aspect of Healthgram’s program is its cost-effectiveness for employers. The program helps avoid expensive medical treatments by managing risks early and ensuring pregnancies progress smoothly.

By investing in maternity management, self-funded employers can improve the overall health and well-being of their workforce and their company.

To learn more, reach out to a member of our team.