1. Paul E. Jarris MD MBA Association of Sate and Territorial Health Officials January 13, 2012

5.  Danny Bender - MS  Susan Cooper – ASTHO Alumni (TN)  Bill Hacker – ASTHO Alumni (KY)  Suzanna Dooley - AR  Norm Hess - MOD  Lauren Ramos - AMCHP  Ellen Pliska - ASTHO  Kathy Vincent - ASTHO  Chris Dang - conference planner

6. Improve birth outcomes by reducing infant mortality and prematurity in the United States Objectives:  Focus on improving birth outcomes as SHOs and state leadership teams work with state partners on health and community system changes  Create a unified message and strategy that builds on the best practices from around the nation  Develop clear measurements to evaluate targeted outreach, progress, and return on investment 6

7. GOODNESS: Reduce preterm births by 8% by 2014 (based on 2009 level) FAIRNESS: Close the Racial Ethnic Gap

8.  Implement state policy change to eliminate elective inductions and c sections prior to 39 weeks gestation ◦ Hospital Policies ◦ Payment – Medicaid (Waivers) ◦ Individual, Provider Education  Improve access to care for all women o reproductive age including 17-P as clinically indicated  Develop and implement a regional campaign to address the following aspects of women’s health: ◦ Life Course Health – preconception/pregnancy/inter-conception ◦ Smoking cessation, especially for pregnant women ◦ Chronic conditions – obesity and diabetes ◦ Influenza immunizations for pregnant women  Safe Sleep

9.  Policies  Community Development and Resources  Patient/Consumer Resources  Health Care Improvements  Data and Information to Drive Action  Payment and Incentives

10.  National Groups  Federal, State, Local and Regional Groups  Public and Private Groups ◦ Employers ◦ Insurers ◦ Consumer groups

11.  Childbirth Connection  Physician Consortium for Performance Improvement  American Academy of Family Physicians  American Board of Obstetrics and Gynecology  American College of Nurse- Midwives  American Congress of Obstetricians and Gynecologists  America’s Health Insurance Plans  Association of State and Territorial Health Officials  Pacific Business Group on Health  The Joint Commission  March of Dimes  Association of Women’s Health, Obstetric and Neonatal Nurses  Hospital Quality Alliance  Leapfrog  National Association of Medicaid Directors  National Association of Public Hospitals and Health Systems  National Committee for Quality Assurance  National Initiative for Children’s Healthcare Quality  National Partnership for Women and Families  Network for Regional Healthcare Improvement

12.  2010: target for hospitals was a cesarean section and/or induction rate of less than 12% of the total number of non-medically indicated deliveries occurring between the 37th and 39th week of gestation.  2011, Leapfrog lowered the target to 5%  Major Employers ◦ FedEx, UPS ◦ General Motors, Toyota ◦ Qwest, Sprint Nextel, Verizon  Major insurers ◦ Aetna ◦ CIGNA ◦ United Healthcare ◦ WellPoint  Hospital Survey  MOD Toolkit

13.  Providing states with template for making the “economic impact argument”  Analysis of key components of successful Medicaid waivers  Coordinating with national partners  Focus on health disparities

14. What will you do by Tuesday?