OptumHealth's Neonatal Resource Services (NRS) helps control and reduce neonatal care costs with effective case management, guiding patients to the highest quality and most efficient facilities and appropriately monitoring the level of care provided.
Since the NRS program inception, the NRS telephonic/onsite case management model has resulted in a reduction in the average length of stay (LOS) by up to 15 percent1 and readmission rates have been lowered by 50 percent.2
NRS provides onsite and telephonic case management to help guide high-risk members to the best NICU providers. These case managers manage NICU cases inpatient and post-discharge to reduce costs and improve outcomes. NRS has a dedicated team of specialized, experienced neonatal intensive care unit (NICU) nurse case managers and full-time medical directors who are well-equipped to facilitate and coordinate care for fragile neonates.
The NRS program is often integrated with the OptumHealth Maternity Programs in order to identify high-risk pregnancies prior to delivery. Once identified, the case manager will educate the member about their care options and the benefits to delivering at a level II or III NICU facility. The rising incidence of multiple births is a major factor in spending on neonatal care. 50 percent of twins and 90 percent of triplets are likely to deliver preterm and ultimately be admitted to the NICU.3 If an infertility program is offered to members, NRS should also be considered.
1 The average length of stay compares baseline prior to NRS (2002-2004) vs. telephonic/onsite model using UHC FI Q2 2009 HCTA NICU/Extended Stay cost per day plus professional fees $3,547.
2 The readmission rate is based on baseline prior to NRS (2002-2004) vs NRS managed (2005-2007).
3 Center for Health Statistics, final natality data.