2024 Annual Perinatal Chart Review

The perinatal study is conducted annually by the Capital District Physicians’ Health Plan, Inc. (CDPHP^®) quality improvement nurse specialists (QINS). The criterion for this study is based on the standards set forth by the 2009 New York State Medicaid Prenatal Care Standards that replaced the Prenatal Care Assistance Program (PCAP) model. The updated New York standards incorporate evidence-based practice, professional guidance from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), and expert input through collaboration with the New York State Department of Health (NYSDOH). The documentation standards are available in Section 13 of the Provider Office Administrative Manual (POAM). The POAM can be found in the CDPHP secure provider portal.  

Ten provider groups (OB/GYN and primary care practitioners) were reviewed for compliance with the CDPHP 2024 Perinatal Health Maintenance Guidelines for members in the Medicaid line of business. The random sample consisted of 35 women across the ten provider groups who delivered between Nov. 6, 2022 and Nov. 5, 2023.

The goal for each question by provider group was a score of 90 percent. The overall 2024 study average of 91 percent did meet this goal.

Overall, 21 questions did not meet the study’s goal of a 90 percent completion rate. Among these 21 questions, 13 questions still saw increased rates when compared to the 2023 perinatal study:

• Is there evidence that WIC form was completed, if applicable (36 percentage-point increase)
• 32-36 weeks: GC and chlamydia cultures, based on risk (23 percentage-point increase)
• Identify infant’s MD (33 percentage-point increase)
• Oral health needs (32 percentage-point increase)
• Patient being treated for depression (32 percentage-point increase)
• Identify infant follow-up care (22 percentage-point increase)
• Influenza given during prenatal visits (18 percentage-point increase)
• Full systems review (15 percentage-point increase)
• Breast exam (10 percentage-point increase)
• Smoking assessment (9 percentage-point increase)
• Postpartum visit (8 percentage-point increase)
• Adjustment to infant (5 percentage-point increase)
• 8-20 weeks: MSAFP (1 percentage-point increase)
• Abdominal exam (1 percentage-point increase)

We request that all physicians and providers of obstetrical care review and consider these study results and assess your documentation practices to ensure they reflect the care that you provide. This review will again be performed in 2025.