Tampa General Hospital (TGH) is the Florida Perinatal Quality Collaborative’s (FPQC) 2020 John Curran Quality Improvement Award winner for its efforts to expand mother’s access to long-acting reversible contraceptive (LARC) options in the immediate postpartum period. In their application, Tampa General submitted its quality improvement project titled “TGH Access LARC Initiative.”

The John Curran Quality Improvement Award, through a competitive process, annually recognizes a Florida delivery hospital that has made a measurable and sustained positive change in a major perinatal quality improvement indicator/issue through implementation of quality improvement activities within the last three years.

Rachel Rapkin, MD, MPH, FPQC’s physician champion and the TGH team: Lindsay Greenfield, MSN, APRN, A-GNP-C, Data Lead; Jewel Brown, MD, Resident Champion; Sherri Badia, Interim Director, Women and Children’s Hospital and Administrative lead; and Danielle Brennan, Labor and Delivery Manager and Nurse Lead accepted the award at a presentation at TGH on Wednesday, March 11.  FPQC Director, Bill Sappenfield, and FPQC Founding Director, John Curran, were on hand to recognize the team for the award and to present a celebratory cake. 

Unintended pregnancies are an important public health issue, and preventing short birth spacing through long acting reversible contraceptives (LARC) is one of the most effective ways to counteract and prevent adverse maternal and newborn morbidity.  In July 2016, Florida Medicaid unbundled the fee for LARC devices from delivery reimbursement, making it possible for hospitals to recover costs for providing the devices immediately postpartum.  TGH joined the FPQC Access LARC initiative and worked on updating policies and procedures, modifying IT systems, educating staff, and testing billing processes to assure this option could be offered.

TGH quickly began placing LARCs for women right after delivering, but was reimbursed for 10% of the devise placed. They worked collaboratively with FPQC, the Agency for Health Care Administration, and the various Medicaid Managed Care Organizations to rectify their internal system structure to effectively manage the unbundling billing process.

The team’s efforts and persistence resulted in fully implementing the service, steadily increasing the numbers of LARCs placed, and obtaining Medicaid reimbursement.  This collaborative work successfully increased reimbursement to over 80% and climbing. They developed a standardized approach that can be adapted by other Florida delivery hospitals to offer this important service that provides effective postpartum contraception.

For more information on this FPQC quality improvement initiative, visit our Access LARC project website.