An international prize committee has recognized a local doctor who spearheaded a state program that helps prevent premature births, saving South Carolina’s Medicaid program more than $7 million in medical costs.
Dr. Amy H. Crockett received the John P. McNulty Prize of $100,000 from the Aspen Institute for her success instituting the CenteringPregnancy model of group prenatal care across the state. The effort first began as a Liberty Fellowship project.
The project helps more than 3,000 women in the state’s Medicaid program, successfully reducing the number of babies born before 37 weeks gestation. It also has increased breastfeeding, lowered rates of cesarean deliveries and reduced gestational diabetes, said Crockett, an OB-GYN and maternal-fetal medicine physician who is the medical director of the Greenville Health System OB-GYN Center. Crockett also is the clinical lead for the South Carolina Birth Outcomes Initiative and a Liberty Fellow.
The McNulty Prize recognizes the best leadership projects among the 2,300 Aspen Global Leadership Network fellows, including Liberty Fellows, across 50 countries.
The CenteringPregnancy model involves having pregnant women meet monthly at their doctor’s office with trained health professionals and other pregnant women to learn about maintaining a healthy pregnancy.
“It changes the doctor-patient relationship, taking the hierarchy out of it,” Crockett said. “Pregnancy can be very isolating, even when it’s planned, so the groups give women a tremendous amount of support, and they enjoy the education and information they get.”
One of the project’s striking results was that it eliminated racial disparities in preterm births among the thousands of women enrolled in the program. In South Carolina, 14 percent of black pregnant women and 9.8 percent of white pregnant women have preterm births, meaning their babies were born before 37 weeks and likely needed support from a neonatal intensive care unit (NICU), Crockett said.
The program resulted in pregnant women – both white and black – having an 8 percent preterm birth rate, she adds.
Researchers do not know exactly why the racial disparity completely disappeared, but they believe it suggests that preterm birth rates are impacted primarily by socioeconomic issues, which were addressed with the CenteringPregnancy model, Crockett said.
“We have a lot of research going on right now to understand why this group model is helping women,” she explained. “We see definite improvements in social support as women are building friendships through these groups, and we see reductions in stress.”
Each group session involves a CenteringPregnancy coordinator who engages patients in discussions about their pregnancies, their prenatal health and child preparation. The women often say they find answers to questions they didn’t know to ask, Crockett said.
“The challenge is convincing practices that this is something they need to do,” Crockett said. “It’s such a change in the way patients move through their offices, and it requires a certain volume of obstetric patients to get women into the monthly group.”
While the insurers – not the physicians – directly benefit financially from healthier babies and mothers, some still have been reluctant to share in the cost of the program.
A recent study, in which Crockett is listed as a co-author (as Amy Picklesimer), in the Maternal and Child Health Journal showed that CenteringPregnancy reduces the incidence of low-birth-weight babies by 44 percent and results in a cost savings of $22,667 for every premature birth that is prevented.
The project, originally for three years, was extended for another three years, and it was expanded from 10 doctor’s practices using the CenteringPregnancy model to 16 sites.
“We will use the prize money to support some of the research we are doing in order to understand how Centering biologically works to decrease the rates of preterm birth,” Crockett said.