AHA Center for Health Innovation Market Scan
St. John's Medical Center – Prenatal Entry Program
The Prenatal Entry Program (PEP) exists to incentivize entry for low-income families to enroll in prenatal care. Patients living at 200 percent of the federal poverty level (FPL) are eligible for the full amount of available funding ($500) to put toward OB initiation fees. Patients with higher incomes are eligible for partial funding support depending on their income level. Historically, almost all of the patients participating in PEP have lived at or below 133 percent of the FPL. To incentivize first-trimester participation, PEP grants an additional $100 for patients who apply early. All funds go directly to the health care provider, thereby absolving patients of administrative wrangling. In accordance with St. John Medical Center’s (SJMC’s) Patient Assistance guidelines, El Puente screens applications, a portion of whom are referred by Teton County Public Health. Income-qualified women receive $600 toward the $750 entry fee if they apply in their first trimester; $500 if they apply in their second or third trimester. By design, PEP is more generous than Wyoming Medicaid.
What is it?
The Prenatal Entry Program (PEP) exists to incentivize entry for low-income families to enroll in prenatal care. Patients living at 200 percent of the federal poverty level (FPL) are eligible for the full amount of available funding ($500) to put toward OB initiation fees. Patients with higher incomes are eligible for partial funding support depending on their income level. Historically, almost all of the patients participating in PEP have lived at or below 133 percent of the FPL. To incentivize first-trimester participation, PEP grants an additional $100 for patients who apply early. All funds go directly to the health care provider, thereby absolving patients of administrative wrangling. In accordance with St. John Medical Center’s (SJMC’s) Patient Assistance guidelines, El Puente screens applications, a portion of whom are referred by Teton County Public Health. Income-qualified women receive $600 toward the $750 entry fee if they apply in their first trimester; $500 if they apply in their second or third trimester. By design, PEP is more generous than Wyoming Medicaid.
Who is it for?
Uninsured, low-income pregnant women, including undocumented residents in the area or those with a temporary HB2 work visa, who cannot receive Medicaid.
Why do they do it?
The Prenatal Entry Program was formed in response to six uninsured patients delivering at SJMC within a matter of several months in 2008-2009, five of whom required emergency procedures. This short-succession series of high-risk deliveries raised alarm bells among community service and health providers; they resolved to establish a solid safety net for the most vulnerable residents of Teton County.
Impact
The goal is 100 percent prenatal coverage, regardless of demographics, insurance or other barriers. That goal has been achieved in Teton County thanks to PEP. Since the program’s inception in 2010, 100 percent of pregnant women in Teton County have received prenatal care; first trimester enrollment in prenatal care has jumped from 61 percent of program participants to 81 percent, and C-section rates – already low – have declined even further.
Contact: Jennifer Simon
Vice President, St. John’s Hospital Foundation
Telephone: 307-739-7529
Email: jsimon@tetonhospital.org
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