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Will Synthetic Hormone to Reduce Costly Preterm Births?
Kyung M. Song | Seattle Times
August 25, 2009
Nikole Montez delivered her first baby 18 weeks early. Her son weighed just 14 ounces and had a heartbeat, which soon stopped.
When the Aberdeen woman became pregnant again a year later, her insurer, Molina Healthcare, the state’s largest Medicaid contractor, identified her as a candidate for a novel therapy: synthetic hormone shots to prevent a recurrent — and sometimes hugely expensive — premature delivery.
The drug, commonly called 17P, has not been approved by the Food and Drug Administration (FDA). Many health plans do not cover it routinely because they consider it experimental.
But under a pilot effort started two years ago in Washington state, Molina educates physicians about benefits of 17P and even helps identify candidates for it. It’s part of Molina’s aggressive management of health care for poor women and children, the mainstays of its business.
Those efforts have helped the California-based company do what many hospitals and doctors insist is all but impossible: make a profit serving Medicaid patients.
Taxpayers have a stake in Molina’s performance. Medicaid, the state-federal health program for the poor, pays for the births of nearly half of all newborns in Washington — more than $15,000 each, or $625 million in total, in 2007.
