The Health of America

Bibb Medical Center in rural Bibb County, Alabama, has figured out a way not only to keep its emergency room open, but to transform itself into a thriving healthcare system. Their success comes at a time when rural hospitals are closing or in trouble across the country. Bibb may be a blueprint for other rural hospitals that could play an even bigger role in keeping their communities healthy. In this episode of the Health of America podcast, learn how Bibb Medical Center is beating the odds.

In 2009, when infant mortality rates were going down in most places, Baltimore’s infant mortality rate spiked to its highest ever. For white babies, the rate was 3.5 per 1000. For African American babies, 18. Black mothers were dying at higher rates, too. The city needed not just a new program, but a whole new approach to saving babies and keeping mothers healthy. That approach, called B'more for Healthy Babies, has saved lives. Now, as the initiative enters its second decade, there's new urgency to save mothers, too.

Rising rates of chronic disease before pregnancy mean women are facing more health risks while they’re pregnant and when they deliver. A new initiative led by Blue Cross & Blue Shield of Mississippi is helping women get healthier first and working with hospitals to adopt new safety protocols.

Giving birth has been getting riskier for women in the United States.

The prevalence of conditions such as high blood pressure, diabetes or obesity are some of the driving forces behind that increasing risk. They can turn dangerous – or even deadly -- before, during or after childbirth for mother and baby.

Reversing the trend will take partners across the healthcare system. Blue Cross & Blue Shield of Mississippi is taking the lead in a state where women face higher risks than in many other states.

In this episode of the Health of America podcast, we head to an OBGYN practice in Biloxi, Mississippi, where doctors are adding chronic condition management to their services. We’ll visit one of the state’s largest maternity wards to learn how doctors and nurses are training for pregnancy emergencies. And we’ll learn more from experts at Blue Cross & Blue Shield Mississippi about the statewide collaboration that’s saving lives and keeping women safer.

Overdose survivors come through this busy Newark ER nearly every day, many of them returning patients. Doctors and nurses don’t always have the time or resources to connect patients right away to addiction treatment. Horizon Blue Cross and Blue Shield of New Jersey saw a window of opportunity in the ER. The health plan and a partner hospital system have embedded peer recovery specialists, right in the ER. They're on the ER team, with an office right near exam rooms. And they can literally rush to the bedside before a patient is discharged.

In some rural Tennessee counties, infant mortality rates are as high as they are in many third world countries. Part of the reason: a lack of access to the right healthcare. Rural women facing high risk pregnancies miss out on the specialty care they need to avoid complications. They may lack transportation, money for gas, or time off work. Now, in a growing number of counties, they don’t have to miss those critical appointments. BlueCross BlueShield of Tennessee is partnering with obstetrics specialists in Chattanooga on a major telemedicine network to serve rural women. Proof it's working: a growing number of healthy moms and babies.

Rural America is struggling to attract and keep doctors. One reason: most doctors end up practicing where they train, which is usually in a metropolitan area. What's more, many rural hospitals are closing. Add to that the fact that some rural residents face higher rates of chronic disease. It's a crisis in the making for rural communities. Blue Cross and Blue Shield of Nebraska asked this question: why not train doctors in small towns? An investment in that strategy is paying off, providing thousands of dollars in scholarships for students who agree to stay and practice in rural areas.

In Newark, New Jersey’s South Ward neighborhood, chronic health conditions are cutting lives short. In the hardest hit ZIP codes, healthy food, convenient transportation and primary care doctors are hard to come by. Many people go the emergency room when they’re sick. What if you approached patients right in the ER, and offered a personal health team to help them get the regular care they need? That’s the pilot program underway at Horizon Blue Cross and Blue Shield of New Jersey, where data about poor health in these neighborhoods inspired a new approach.

Construction workers in Massachusetts are six times more likely to die from an opioid overdose than workers in any other profession. Overdoses are even happening more and more on the job. Who do you bring to the table to tackle a problem like that? Shawmut Design and Construction decided to speak out and ask for help. That help came from what might seem an unlikely source – their health insurer. But as they began to tackle the problem together, all the right building blocks were there. In this episode, we head to a construction site, where, until recently, addiction was a private struggle. That’s changing, thanks in part to the team who custom-designed a lifesaving kit for the industry.