MISSION, KS--(Marketwire - December 27, 2010) - (Family Features) With state and federal budgets stretched thin, and cost-cutting a primary motivator for insurers, programs providing healthcare services for our tiniest citizens -- especially premature infants -- are becoming more limited and restrictive. But, being armed with the right information can help parents best navigate what health issues to watch out for and how to best protect their family in this rationing environment and, in particular, during this time of year.
Parents of Preemies Take Note
Preemies are at increased risk for a variety of health complications, including respiratory illnesses and chronic lung disease -- even if they're born just a few weeks early. This is because they have underdeveloped lungs and immature immune systems in comparison with full-term babies.
As we approach the winter season, and seasonal viral activity escalates, it's important that parents of preemies understand their baby's health risks and ensure they have access to a variety of therapeutic options to help keep them healthy. For example, in addition to colds and the flu, there is another common virus that can be especially serious for the premature infant population: respiratory syncytial virus (RSV). RSV is a common, seasonal and easily spread virus that infects nearly all children by their second birthday. Most kids just get moderate to severe cold-like symptoms, however high-risk infants may get severe RSV disease. RSV disease is the most common cause of death due to a virus in children under five years of age and is responsible for an estimated 125,000 infant hospitalizations annually in the United States.
There are simple ways to help protect your baby from viruses such as RSV, including washing hands and bedding frequently, and limiting your baby's exposure to large groups and environmental tobacco smoke. And, of course, speak with your child's healthcare provider about any concerns and other prevention options.
Preemies Now Face Added Challenges
While being diligent about monitoring the health needs of your little one greatly helps them live a healthy life, it's also important to note how current economic pressures and their impact on the healthcare system can affect your baby's access to services.
In particular, preemies and other vulnerable babies have been facing additional challenges because of healthcare system constraints, which are creating more restrictive reimbursement policies and forcing program cuts that limit access to care. Across the country, for example, 45 percent of local health departments experienced budget cuts in 2009, which led to nearly a quarter of these departments reducing funding for maternal and child health programs, such as Medicaid's Women, Infants and Children (WIC) program.
Private and public insurers alike are also creating barriers to care by using increasingly restrictive care guidelines to drive their eligibility decisions. For example, in 2009 the American Academy of Pediatrics issued more restrictive guidelines for RSV emphasizing cost issues over new or existing clinical data.
"One of the biggest challenges to ensure infants have access to the proper care they need is that insurers are adopting guidelines without considering all available clinical evidence, rather than analyzing high-risk infants on a case-by-case basis under the direction of the child's physician," said Dr. Mitch Goldstein, president of the National Perinatal Association.
What Can Parents Do?
If you're the parent of a preemie, talk with your child's pediatrician about proper prevention for all illnesses, such as respiratory illnesses like RSV disease. "If healthcare coverage is denied, you can likely appeal the decision. Your doctor should be able to advise you on the appeals process and share additional resources that can help you," said Dr. Goldstein. "When there is advocacy from both the parent and the physician, there is more likelihood of success."
All babies deserve equal access to preventive care, and physicians, nurses, payers and parents must work together to protect them. Go to www.preemievoices.com or www.nationalperinatal.org for more information on preemies and infant health. To learn more about the signs, symptoms and risk factors of RSV disease, as well as additional prevention tips, visit www.rsvprotection.com.
