Early Elective Delivery Reduction Initiative

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Issue: An early elective delivery (EED) is a delivery that occurs prior

to the 39th week of pregnancy without having a medical indication to
do so. Research has shown there is no medical benefit for mother or
baby and instead is associated with higher morbidity and mortality in
infants as well as higher rates of NICU and MICU admissions.

Initiative: Many states have been successful in reducing EED

through the implementation of effective techniques such as hard
stop policies in hospitals and reducing or eliminating reimbursement
for EED by insurance companies and Medicaid. Other states have
found that policies that focus on payment are most effective. By
making changes to Medicaid policy, Illinois has the opportunity to be
equally as effective in reducing EED.

Making the case to

eliminate EED

1. Strong medical evidence

for reduction of neonatal and
maternal harm
2. Strong support from
professional organizations,
including the American
College of Obstetricians and
Gynecologists (ACOG), the
Association of Womens

EED Facts
- The national average EED rate has decreased from 17% in 2010
to 4.6% in 2013.
- Elective induction doubles cesarean delivery rates

Health, Obstetric and

Neonatal Nurses
(AWHONN), and the
American College of NurseMidwives (ACNM)

- Babies born early may experience difficulties staying warm,

breathing, and feeding
- Preterm infants are at higher risk for experiencing learning and
other developmental delays later in life

3. Transparency: public
reporting by multiple
organizations (some required)
4. Quality Improvement tools

Action plan: There are many local and national players working

and help available, including

state quality collaboratives,

toward reducing EED rates. Through continuing to work with local

stakeholders and by partnering with IL legislators, successful
Medicaid policy change requiring hospitals to cease the scheduling of
these procedures can occur. Simultaneously, work to educate the
general public as well as medical providers on the dangers of early
delivery should continue. Additionally, continuing existing measures,
such as mandatory reporting of PC-01 data will continue to hold
hospitals accountable for their rates of EED.

Hospital Engagement

Contact: Anna Calix, UIC SPH, acalix2@uic.edu

hospitals doing well,

Networks
5. Part of Pay-forPerformance models by CMS
and commercial payers
6. Established ongoing
national project with most
remaining hospitals are
outliers