Maternity Care Model

With four million deliveries per year, birth is one of the most common reasons for hospital use in the US and is a huge expense for payers. Today, the US spends almost $82 billion per year on maternity care each year. Yet despite rapidly rising costs, national perinatal outcomes have not improved significantly over the last 15 years.

CERC’s maternity care redesign team set out to identify the major challenges in current methods to deliver high-quality obstetrical care. Team members addressed these via a new care model with these elements:

·      Provide long-acting reversible contraception (LARC) immediately after birth, safely and effectively reducing both unplanned repeat pregnancies and the high rate of costly complications associated with short-interval pregnancies.

·      Tailor prenatal care according to women’s unique medical and psycho-social needs with more efficient approaches. These include fewer in-person visits, which can allow providers to spend time seeing higher acuity patients, and group prenatal care, which has been shown to reduce the preterm birth rate in certain high-risk groups.

·      Create hospital-affiliated integrated outpatient birth centers as the planned place of birth for low-risk women to avoid the very expensive and unnecessary inpatient facility fees and reduce the risk of unnecessary cesarean sections and other procedures.

The CERC team estimated that savings from full implementation of the model is $23 billion dollars in direct health care spending per year nationally, or 28% of annual spending for maternity care.

Team: Victoria Woo, MD, Tiffany Lundeen, MSN, Terry Platchek, MD, Sierra Matula, MD, MSHS, Arnold Milstein, MD, MPH

 

Published by CERC Faculty and Fellows

 

Achieving higher-value obstetrical care

American Journal of Obstetrics and Gynecology, Available online 29 December 2016, ISSN 0002-9378

Hospital-Affiliated Outpatient Birth Centers: A Possible Model for Helping to Achieve the Triple Aim in Obstetrics.

JAMA. 2016;316(14):1441-1442. doi:10.1001/jama.2016.11770