Mothers: A Surprising Benefactor of Value-Based Care

Yesterday, the Centers for Medicare & Medicaid Services renewed their call to reward providers for boosting quality, and a group of public and private healthcare leaders organized by the Department of Health & Human Services called the Health Care Payment Learning & Action Network released new goals to accelerate value-based care reform through shared accountability alternative payment models (APMs). While these models are designed with complex care in mind, a surprising benefactor could be pregnant and new mothers.

That’s because these shifts to value-based APMs, are pushing U.S. healthcare providers to transition from siloed services to team-based care models with incentives that support moms through their entire journey from pregnancy through post-partum. That’s good news for our country, where so many moms – especially moms of color – are dying.

Challenges Remain

Incentives that support a holistic integrated, approach to maternal care are a big deal. Today, two-thirds of U.S. hospitals identify poor health literacy and self-care as top contributors to the nation’s maternal mortality crisis, according to a Premier survey. These hospitals see first-hand the challenges that many pregnant and post-partum women face when trying to find transportation to visit the doctor, access to affordable healthy food, help with addiction and other behavioral health issues, and safe home environments.

As one of the nation’s largest depositories of health data spanning more than 4,000 health systems and 175,000 other providers, Premier has visibility into real-time insights that go beyond what’s available to government agencies. While the industry is largely focused on saving mothers by improving hospital care, such as cesarean births and obstetric hemorrhaging, the evidence clearly demonstrates the more substantial opportunity is in closing gaps in social determinants of health.

Delivery-Related Maternal Deaths in the Hospital are on the Decline

The nation’s maternal mortality crisis points to a major flaw in our reimbursement system to incent care providers across the continuum to work together to support women and their families. This is an epidemic that cannot be solved in the labor and delivery room alone – particularly as our data show that contrary to popular belief, delivery-related deaths in the hospital are actually declining.

The move to value-based care is an important shift that will save mothers through whole-person care. Our data demonstrate that IT systems that facilitate better communication between providers and comprehensive and real-time data that provides insights into the many forces that influence maternal health will enable it. But the incentives need to be there for providers to make these investments.

This mindset shift is dire. More than 90 percent of hospital and health system leaders indicate that they do not currently participate in a risk-based payment model with an insurer or employer that is focused on maternal and infant health. While disparities in maternal health outcomes relate to broader structural inequities that cannot be solved by changes in payment alone, it is time for us to help reduce these disparities in outcomes as a part of outcomes-driven value-based care.

While many factors are at play in determining how parents experience the birth of a child – death or near death of mothers should never be one of them. We can and must do better.

To learn more about Premier's efforts to improve maternal health visit www.premierinc.com/bundleofjoy