Guest blog by John J. Donahue, Chairman and CEO, axialHealthcare
Every 15 minutes, a baby is born suffering from neonatal abstinence syndrome (NAS), which is a drug withdrawal syndrome experienced by newborns who have been exposed to opioids or illicit substances while in utero.
I’ve had the opportunity to visit several neonatal intensive care units (NICUs) at hospitals across the country during my 30-year career in healthcare, and have seen the tremendous pain these innocent newborns experience only a few days after being brought into this world. Instead of going home with their families a couple days after birth, babies with NAS are watched closely by hospital staff in the NICU for a minimum of seven days and sometimes several weeks due to drug withdrawal symptoms, including fevers, dehydration, sweating, tremors, high-pitched crying, hyperactive reflexes, and more.
Amid our generation’s most challenging healthcare crisis – the opioid epidemic – newborns with NAS are sadly on the rise, and states across the nation are seeking innovative solutions for this issue that is straining communities emotionally and financially.
According to a recent study, the rate of U.S. infants diagnosed with NAS increased 433 percent over 10 years (1.5 to 8.0 per 1,000 hospital births between 2004 – 2014), and among infants covered by Medicaid, NAS incidence increased more than fivefold during the study period (2.8 to 14.4 per 1000 births). The same research shows that hospital stays for Medicaid-covered infants without NAS average around $3,700, but hospital stays for infants born with NAS range from $19,340, when adjusted for hospital inflation, to as high as $66,700. These costs fall to the state Medicaid programs, which cover an estimated 82% of NAS births.
With more Americans facing dependency on and addiction to opioids as the epidemic continues to evolve, axialHealthcare has made it part of our mission to support those populations impacted. In October 2017, we released axialINSIGHT 3.0 to support improved care to those with opioid use disorder (OUD). However, there are subpopulations, such as women of childbearing age and expectant mothers, who have very specific care needs that are not currently being met within today’s market.
It is for this reason that we launched a new effort to improve maternal and infant outcomes for this vulnerable group. Built on our extensive repository of claims data and peer-reviewed evidence, axialINSIGHT, our technology and advanced analytical models can now identify women who are pregnant or of childbearing age and have elevated opioid risks.
Once a patient has been identified as high-risk for a NAS birth, we’re able to engage their physician and provide them with evidence-based care pathways that address opioid tapering and cessation, chronic pain, opioid use, and OUD during pregnancy. Early identification of at-risk patients optimizes a physician’s window for intervention for the smallest victims of the opioids crisis, infants born with NAS, and allows us to direct these patients to highly coordinated care between addiction medicine specialists, behavioral health coaches, and OB-GYNs who have proven outcomes for high-risk pregnancies.
Blue Cross and Blue Shield of Alabama is the first health plan in the nation to embrace our NAS technology.
“Alabama providers wrote 5.8 million prescriptions for opioids in 2015, ranking us as the highest prescribing state in the nation,” said Dr. Anne Schmidt, Medical Director for Blue Cross and Blue Shield of Alabama. “We’ve seen the direct impact of NAS within our state and are excited to be the first to implement axialHealthcare’s NAS enhancement to further demonstrate our dedication to member safety and efforts that focus on abating opioid misuse.”
We’re thrilled to have such a progressive and innovative client like Blue Cross and Blue Shield of Alabama as our first partner to implement the NAS solution, and we look forward to improving outcomes for their most vulnerable member population.
Throughout this product development process, we’ve heard from countless partners and friends how important this work is for our communities, and it’s incredibly enlightening to see how many people are dedicated to the care of infants born with NAS. With this new initiative, we hope to join in and support their efforts by intervening at the earliest possible point, supporting women at risk of NAS births with better care, and, when possible, preventing it in the first place.