People who can become pregnant receive substantial preventive care services in OB-GYN and reproductive health clinic settings. Through the Pregnancy Intention Initiative, specialty Blueprint Patient Centered Medical Homes are providing enhanced health and psychosocial screening along with comprehensive family planning counseling, including timely access to long-acting reversible contraception (LARC). New staff, training, and payments support effective follow-up to provider screenings through brief, in-office intervention and referral to services for mental health, substance use, trauma, partner violence, food, and housing.
The Pregnancy Intention Initiative helps ensure that specialty health providers, Patient Centered Medical Homes, and community partners have the resources they need to help women be well, avoid unintended pregnancies, and build thriving families.
A complete list of Vermont Blueprint practices that participate in the Pregnancy Intention Initiative is available with a link to their website.
Click here for Implementation Materials.
Healthier People, Children, and Families
A few key supports can help Specialty Health providers and Patient Centered Medical Homes be even more effective in providing preventive care, identifying health and social risks, connecting people to community supports, and helping ensure more pregnancies are intentional.
Unintended pregnancies are associated with increased risk of poor health outcomes for parents and babies and long-term negative consequences for the health and wellbeing of the children and adults those babies become. The Healthy Vermonters goal for pregnancy intention is 65%.
Enhanced Screening and Community Connections
The Pregnancy Intention Initiative supports practices in building enhanced screenings into regular specialty health visits. People identified as at-risk in the areas of mental health, substance use, partner violence, or access to food and housing are immediately connected to an initiative-funded social worker for brief intervention and counseling and referral to more intensive treatment as needed. Each behavioral health clinician is a member of the Community Health Team and available to connect people with the local network of health, social, economic and community service providers.
Same-Day Access to Effective Birth Control
Participating practices offer comprehensive family planning counseling which begins by asking the One Key Question regarding pregnancy intention in the coming year. People who tell their providers they do not want to become pregnant in the coming year have access to all contraception options including immediate access to LARC. People who wish to become pregnant receive preconception counseling and services to support healthy pregnancies.
Building Community Referrals
Each participating Pregnancy Intention Initiative practice develops agreements with at least 2 community-based organizations to see their referred patients within one week, however long their waitlist for new patients may be. This helps ensure that people most at-risk of unintended pregnancy have fast access to effective contraception. Each participating Pregnancy Intention Initiative specialty practice also makes an agreement with a primary care practice to accept patients who don't have a primary care provider.
Pregnancy Intention Initiative Payments for Enhanced Screening and Care
The Pregnancy Intention Initiative payments are part of the move from fee-for-service to funding for value-based care. Three payments support Specialty Health practices in the additional training and work and new workflows that are part of the Initiative.
Per-Practice Per-Person Per-Month Payment – supporting enhanced care, screening, and collaboration with the Community Health Team and community-based organizations.
Community Health Team Payment for specialty practices– Supports 1 full time equivalent (FTE) mental health clinician per every 1200 attributed beneficiaries (minimum .5 FTE per practice), for brief intervention and referral to services.
Capacity Payment – one-time initial funding to help practices cover the costs of initially implementing the program including stocking LARC.
Participating primary care practices that are already Blueprint Patient Centered Medical Homes are also eligible to participate and receive the one-time capacity payment, and the per-practice per-person per-month payment.