Approaching 4 million deliveries per year, birth is one of the most common reasons for hospital use in the US and is a top expenditure for payers. Between 2004 - 2010, commercial payments for maternity care increased by over 50%, with out-of-pocket expenses borne by families increasing four-fold. Despite rapidly rising payments associated with childbirth national perinatal outcomes has not improved significantly over the last 15 years.
CERC’s maternity care redesign team identified three addressable failure points in current methods to deliver high-quality obstetrical care. Team members addressed these failure points via a new care model with three core elements
- Women are screened at their first prenatal visit for unmet medical and psychosocial needs. Women without significant unmet needs are scheduled for approximately 30% fewer prenatal visits than has traditionally occurred. Women with unmet needs are scheduled to participate in OB led 90-to120-minute prenatal group visits focused on education in pregnancy related health risk reduction at the same frequency as one-on-one prenatal visits have traditionally occurred.
- Hospital-affiliated and immediately adjacent outpatient birth centers with regularly rehearsed rapid hospital transfer protocols are routinely offered to low risk women desiring less medicalized births by nurse midwives in conjunction with a neonatal specialist.
- Contraception education is provided throughout the prenatal period along with the placement of long-acting reversible contraception (LARC) prior to discharge from the birthing facility for women desiring contraception.
Projects and Outcomes
Net Percent reduction in total annual American health care spending: 0.64%
Net annual savings $23 billion / Total annual American health care spending in 2018 $3.6 trillion