Raffo said MIHP was developed to enhance prenatal care, to help provide care coordination and to screen for basic needs of the mothers-to-be, such as depressive symptoms or the possibility of domestic violence, in addition to a variety of other services. MIHP also offers services after the birth of the infant until the infant is two years of age.

A nine-year research collaboration between the MSU College of Human Medicine and the Michigan Department of Community Health, or MDCH, yielded the opportunity to study the usage of MIHP.

Dr. Lee Anne Roman, an associate professor in the department and one of the lead researchers in the collaboration, said the study was funded by MDCH in an effort to strengthen prenatal programs for pregnant women and to understand the reasons why MIHP was so greatly underutilized.

Raffo said to study the subject, the team pulled together a group of community providers, local physicians, MIHP providers and health plans. The study was conducted in an unidentified community.

Roman said 56 physicians took surveys to gauge their knowledge of MIHP, and of these physicians, 90 percent said it would benefit their patients. The survey also highlighted 60 percent had never referred their patients to MIHP. Another 42 percent said they weren’t even familiar with the program.

“Typically (for) the use of the program, you see higher engagement rates in much smaller rural communities,” Raffo said.

Raffo said in bigger communities it’s harder to raise awareness of the program because of the higher number of people to educate on the services provided by MIHP.

Raffo also said the reasons why physicians are not referring MIHP to their patients is their own lack of knowledge of the program, in addition to the absence of the time required to build up relationships between physicians and the local providers that offer the service. MIHP relies on a network of physicians, nurses and social workers.

“I think the barriers can be overcome based on education,” Raffo said. “I think it has to be more active education. Physicians are inundated with pamphlets about lots of things. It makes it difficult to weed through and absorb all of that.”

Dr. Gareth Forde, one of the researchers on the project and a member of the clinical faculty at University of California, Irvine, said he believes that another way of overcoming the barriers is by sharing responsibility between the patients and the physicians.

“If there’s a way for (patients) to be educated about these services independent of their clinicians, the utilization of the services will be greater,” Forde said.

Roman said it’s important to remember that physicians who work with Medicaid-insured women are passionate about the care provided to these mothers-to-be.

“It’s not that they’re not willing,” Roman said. “We need to make an easy process in a very challenging health care program.”