Outcomes

The Reduction of Infant Mortality in Illinois
2012 Annual Report

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Illinois' integrated strategy for improving maternal and child health focuses on four outcomes:

• Reducing the very low birth weight rate
• Reducing the low birth weight rate
• Reducing Medicaid expenditures during the first year of life
• Reducing the infant mortality rate

Very low birth weight infants (newborns who weigh less than 3 pounds 2 ounces) require intensive medical care. While these infants represent less than two percent of all live births, they also account for two-thirds of the infants who die in the first year of life. Interventions that reduce the very low birth weight rate will also reduce Medicaid expenditures during the first year of life and reduce the infant mortality rate.

The integrated delivery of the WIC and FCM programs affects the state's infant mortality rate and health care expenditures. The health status of infants born to Medicaid-eligible women who participated in both WIC and FCM has been substantially better than that of infants born to Medicaid eligible women who did not participate in either program. In particular, the rate of premature birth is more than 30 percent lower among participants in both programs. The rate of low birth weight is 30 percent lower; the rate of infant mortality is more than 55 percent lower; and on average health care expenditures during the first year of life are almost 30 percent lower.

Very Low Birth Weight

The very low birth weight rate among women who participated in both WIC and FCM was 1.1 percent in 2009, almost a third lower than the rate observed among Medicaid eligible women who did not participate in either program during pregnancy (2.9%).

Medicaid Expenditures in the First Year of Life

The Department matches information from its maternal and child health management information system, Cornerstone, to vital records maintained by IDPH and the Medicaid Management Information System maintained by the IDHFS. This allows the Department to compare the perinatal health status of women and children who participate in several of its programs to Medicaid-eligible non-participants and the general population of pregnant women and newborns.

WIC and FCM, through the reduction in very low birth weight, contribute to a significant reduction in Medicaid expenditures during the first year of life.

As an example, TIPCM served 2,567 women during FY2011, 56 percent black and 96 percent Medicaid eligible. The low and very low birth weight rates for TIPCM recipients were 13.4% and 1.7%, respectively. These rates compare favorably to those reported for the general black population, 13.7 and 3% respectively. The potential costs averted by the program are enormous; all TIPCM recipients are at great risk of a non-normal birth. According to IHFS, in the Perinatal Health Care Report, 2010, a non-normal birth costs approximately $14,000 during the first year of life. Applying this amount to the births of TIPCM recipients (less those that were low or very low birth weight - 343) the state averted $30 million in costs of care that would have been necessary.

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Illinois has made steady progress in reducing its infant mortality rate, in part, due to the improvement of birth outcomes as a result of at-risk women participating in the WIC and FCM programs.