Resulting in more than $3M in savings in health care costs

By, Banner Health

Banner – University Medicine has expanded the services of its Family Centered Neonatal Abstinence Syndrome Care Program with the opening of the MOMs Clinic (Mothers Over Medicine) program.

A part of the Family Centered Neonatal Abstinence Syndrome Care Program, the MOMs clinic was developed to help pregnant, soon-to-be mothers learn new parenting skills to help ease their newborns withdrawal symptoms from exposure to opioids.

The program also provides education and resources to help parents create safe, stable, nurturing relationships and environments for their children. Babies who have been exposed to opioids and some other medications/drugs in utero often suffer withdrawal symptoms in the several days after birth. Withdrawal symptoms can include uncontrollable crying, tremors, vomiting, diarrhea, difficulties with sleep, and other autonomic disturbances.

Babies can develop withdrawal from exposure to heroin and prescription painkillers like Oxycontin, Vicodin and Dilaudid. Babies also can experience withdrawal from exposure to Methadone, Subutex and Suboxone, which are used to treat substance dependence. This is how Kellie Dow, a mother of three, learned about the program.

Dow was prescribed opioid painkillers after knee surgery in 2010 and became dependent upon them. She sought help and quit using opioids in 2016. To help her cope with withdrawal symptoms and to keep from relapsing, Dow is prescribed Methadone for relapse prevention and receives relapse prevention counseling from Cope Community Services’ Substance Abuse Treatment Program. 

Two years ago, a friend of Dow’s at Cope became pregnant and was provided information on the MOMS Clinic at Banner – University Medicine. The friend opted out of the program and had her baby at another Tucson hospital. The baby was in the hospital for six weeks after delivery and received no specialized care for withdrawal.

Dow was on birth control but became pregnant and remembered her friend’s experience. Dow’s coach at Cope recommended she call the MOMs Clinic to learn more about the program. Dow was 20 weeks pregnant at the time and convinced herself to call Joy Subrin, the MOMs contact at Banner – University Medicine OB-GYN clinic.

Subrin is a certified integrative health and lifestyle professional at Banner – University Medical Center Tucson and leads the OB-GYN outpatient clinic social work department. The Banner-UMC Maternal Fetal Medicine OB-GYN team and Subrin have helped to bring in a more integrative approach to the prenatal care model at Banner – University Medicine, helping women in recovery have healthier pregnancies and babies.

The Family Centered Neonatal Abstinence Syndrome Program was established by M.Y. Bader, MD and Lisa Grisham, neonatal nurse practitioner, to advance the care of babies born with NAS (neonatal abstinence syndrome). Because of the program’s success, it has been adopted by hospitals throughout the state. Other Banner facilities in Phoenix are also beginning to manage infants modeled after the Family Centered Neonatal Abstinence Syndrome Care Program in Tucson.

Babies who are born with neonatal abstinence syndrome are hospitalized for on average 22-24 days at a cost of $45,000 to $90,000 per baby.

For comparison, the average cost for a newborn delivery and hospitalization is about $3,500. Families participating in the program remain in the Neonatal Intensive Care Unit on average five to seven days. This program began in the summer of 2017 and subsequently, the MOMS clinic began in 2019. 

To date, 56 infants have been discharged home from Banner – University Medical Center Tucson receiving an average of six days of hospital care versus 22 days, resulting in more than $3 million in savings in health care costs due to decreased length of stay.

“This level of care has become more integrated, by working in collaboration with community programs in Tucson, such as Cope, CODAC, Community Medical Services and Connections Health Solutions,” said Grisham.

In addition, the clinic draws upon a team of physician experts from OB-GYN, neonatal intensive care, psychiatry, social work and community partners to build a judgement-free, compassionate network of support for the soon-to-be moms. The clinic also provides education regarding baby care and strategies for self-care through healthy pregnancy education, community sobriety support, positive coping techniques and peer support.

The clinic also offers individual and group support. Group support includes high quality, small group discussions that work to build and strengthen trust and relationships. A typical office visit normally takes 15 minutes. These group discussions last 90 minutes.  

“We are changing the conversation on substance use disorders and we are training the next generation of doctors in the process,” said Subrin.

Dow and her new baby Maverick, who is now 3 months old, are doing well with the support her husband Michael and their other two children: Austin who is 11 years old and Noah who is 3 years old.

“I wish this program would take off everywhere. There should be a program like this in every hospital in the state. I can’t emphasize enough how incredible and compassionate the doctors, nurses, case workers and other team members are at Banner. They never once made me feel bad for my choices and circumstances,” said Dow.

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