Pregnancy Care Management

The Pregnancy Care Management services (PDF) are provided for pregnant Medicaid recipients who are determined to be at risk for poor birth outcomes. All patients identified as having priority risk factors will be assessed by an OB Care Manager who will then work with the woman and her prenatal care provider to ensure she receives the best possible care while she is pregnant and after delivery. 

Risk FactorsAltText

Priority risk factors include:

  • Chronic conditions which may complicate pregnancy
  • Fetal complications
  • History of low birth weight
  • History of preterm birth
  • Inappropriate hospital utilization
  • Missing two or more prenatal appointments without rescheduling
  • Multiple gestation
  • Substance use
  • Tobacco use
  • Unsafe living environment (homelessness, inadequate housing, violence or abuse)

Screening

All Pregnancy Medical Home (PMH) providers are required to complete a pregnancy risk screening to identify these and other risk factors. Non-PMH providers are able to refer their patients/clients for Pregnancy Care Management (PCM) services using the referral form below.

Make a Referral

To refer pregnant Medicaid recipients who are determined to be at risk for poor birth outcome, please complete the referral form (PDF) and fax it to 704-216-7999, attention: PCM program.

Additional Information

For more information about Care Management programs and services, call 704-216-8867. You can also call the Care Line and Referral Service at 800-662-7030 (English and Espanol). Deaf and hard of hearing callers can dial 877-452-2514.