Both patients and maternity care providers can benefit from payment reform: four steps to prepare

Malini A Nijagal; Neel T Shah; Jeff Levin-Scherz

doi:10.1016/j.ajog.2018.01.014

Both patients and maternity care providers can benefit from payment reform: four steps to prepare

Am J Obstet Gynecol. 2018 Apr;218(4):411.e1-411.e6. doi: 10.1016/j.ajog.2018.01.014. Epub 2018 Jan 12.

Authors

Malini A Nijagal¹, Neel T Shah², Jeff Levin-Scherz³

Affiliations

¹ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA. Electronic address: malini.nijagal@ucsf.edu.
² Ariadne Labs at Brigham and Women's Hospital, Boston, MA; Harvard T. H. Chan School of Public Health, Boston, MA; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA.
³ Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA.

PMID: 29338994
DOI: 10.1016/j.ajog.2018.01.014

Abstract

Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high-quality care at a lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care episode payments and recommend 4 ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste, and work in teams across settings.

Keywords: business of medicine; payment reform; prenatal care; quality of care.

MeSH terms

Efficiency, Organizational
Fee-for-Service Plans
Female
Health Care Reform*
Health Expenditures
Humans
Maternal Health Services / economics*
Medicaid
Patient Care Team
Pregnancy
Quality Assurance, Health Care
Reimbursement Mechanisms
United States