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High risk channeling to improve Medicaid maternal and infant care.

To improve the medical care access of the poorest women and newborns, South Carolina began a High Risk Channeling Project since April 1986. The Project directs physicians to screen all Medicaid-eligible pregnant women and newborns for specified clinical high risk factors. High risk patients are channeled to designated clinics for prenatal and newborn care. Channeled pregnant women are directed to deliver their babies at regional referral hospitals. For the first two years of the Project, about two-thirds of pregnancies and 60% of newborns were actually screened. Channeled women were much more likely than the non-channeled to deliver at higher level hospitals. In counties where relatively few women were channeled, the rate of prematurity among Medicaid newborns was significantly higher than in other counties.