Medicaid could save $186 million over the next 10 years if it uses telehealth services for high-risk pregnancies, according to a new analysis commissioned by the American Telemedicine Association. And that's a conservative estimate, researchers say.

Conducted by Washington, D.C.-based health research company Avalere Health, the new study analyzed Medicaid's costs for pre-term babies, NICU admissions and unplanned physician visits by Medicaid patients. Researchers then applied analytical tools--like those used by the Congressional Budget Office--to create projects that legislators might be more likely to accept, it seems.

The proposal doesn't say exactly which telehealth services the ATA recommends, but it does suggest a series of "birthing networks" similar to one in use by the University of Arkansas for Medical Sciences. The 10-year-old program--Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) network--offers:

• Weekly telemedicine conferences between a patient's physician/OB and maternal-fetal medicine specialists;
• Ultrasound reading via at-home fetal monitors;
• Video-conference training for local technicians on high-risk pregnancy management;
• 24-hour call center service for physicians to consult maternal-fetal specialists;
• Call center for women with questions about pregnancy, delivery and post-partum concerns.

And it's a hefty program. The network provides upward of 150,000 OB support calls to patients and 2,100-plus telehealth visits per year, university officials say. It also earned the university the ATA's President's Institutional Award for the Advancement of Telemedicine this year.

The main goal of the program is to prevent pre-term labor, which ranges from 20 to 45 percent of Medicaid patients, the study reports. Pre-term infants have more costly deliveries, spend more time in the NICU and require more unplanned physician visits than babies that make it to full- or near-full term, researchers explain.

Applying telehealth technology like at-home fetal monitoring and telehealth consults to the problem could help lengthen high-risk pregnancies to closer to 32 weeks, when NICU services and intensive physician follow-up are less likely, researchers note.

To learn more:
- read the ATA/Avalere proposal
- check out the ANGELS program at University of Arkansas Medical Sciences
- get more detail on UAMS' award from ATA from earlier this year

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