Help for our Tiniest Members: How HAP and Progeny Support Babies in Neonatal Intensive Care and Beyond

A baby may be the most frighteningly helpless creature on the planet. Those first few months seem like round-the-clock feeding, diapering and rocking. The whole family’s sleep, eating and work schedules can go off balance. Mom is recovering from the delivery. She may be hormonal, struggling with nursing, sleep-deprived. Older siblings still need meals, baths, clean clothes, homework help and cuddles. It can be a joyful time and a challenge for any family.

Add the needs of a medically fragile baby, starting life in a neonatal intensive care unit, and it can be overwhelming. With medications, medical equipment, doctor appointments and middle-of-the-night emergencies, it’s a lot to handle. Parents need expert help.

A partnership to provide support

To give them that help, HAP has partnered with ProgenyHealth to create a NICU Care Management Program. Progeny is an industry leader in case management for premature and medically complex newborns.

They have an experienced team of pediatric and newborn care experts. It includes nurses, social workers, a pediatrician who specializes in newborns and a breast-feeding consultant. They understand what the family is facing. And they can anticipate and fill their needs.

Having a baby in a NICU or pediatric care nursery can be scary and stressful. On top of concerns about the baby’s health, a family that was planning to be home with baby is now divided between home and the hospital. The parents of a premature baby may not be ready with a car seat, crib, diapers or child care for older siblings.

Progeny case managers reach out quickly to let parents know they’ll have help while their baby is in the NICU and after.

Medical care and more

“The case manager helps the family navigate the healthcare system. Quite a few of the babies need to be enrolled in Medicaid. And they may also have insurance with HAP. The Progeny case manager helps them apply for Medicaid and helps them coordinate benefits,” says Illana Hearshen, leader of the HAP team that implemented the program.

When baby goes home, Progeny case managers organize medication and equipment. And they make sure parents know how to care for their infant. Some of these babies face a lifetime of disability or illness. Progeny’s staff works with the family to get Supplemental Security Income or SSI.

But they’re not just there for the baby. They assess all the family’s needs. Do they need child care for other children? Maybe the family already has a special-needs child that needs support.

A low-income family may need help with basics such as transportation to and from the hospital, housing, formula and diapers. They may need help applying for The Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC.

Progeny’s social workers can help.

“They connect families with local resources for expenses not covered by insurance.” says Hearshen, “These might include United Way 211 to get bills paid, food assistance through food banks, mom-to-mom sales to get baby clothes and equipment.”

Help through the first year

Once the baby is home, the family can call a case manager 24/7 for help or advice.

“Any need they call in with, we have the staff to cover that,” says Dina Faust, Progeny’s supervisor of Case Management. “A lot of times, moms will call in with something as simple as ‘I don't have any formula’ or ‘we ran out of medication.’ Or it may be as serious as baby has a fever or baby is spitting up or not tolerating the formula. Our role is to guide them to the appropriate response or resource.”

Progeny case managers work with families until baby’s first birthday. In addition to medical expertise, they often provide much-needed support to parents.

More than a case manager

Progeny Case Manager Gabbie Seaman says, “It kind of turns into a friend. You're a person they trust with talking about this baby. A mom with twins always calls back with updates on the babies. We laugh, we've cried over things that happen with these little ones. Especially with these premature babies, every milestone is a big deal.” One mom, says Seaman, took the time to call as her baby was being rushed to the emergency room.

An award-winning success

Since 2016, HAP’s NICU Care Management Program has reduced the number of babies readmitted to the hospital by 60 percent. In September 2018, the Michigan Association of Health Plans recognized the program’s success with a prestigious Pinnacle award for Clinical Service Improvement.

Categories: Get To Know Your Plan