Postpartum
Jul 21, 2024
Danielle Fernando, RN
In recent years, there's been a growing recognition that our healthcare system needs to shift from volume-based care to value-based care.
Nowhere is this more critical than in maternity care, where the stakes are high and the potential for improvement is significant. Let's explore how value-based care is revolutionizing the postpartum experience and why it matters for new mothers, healthcare providers, and health plans alike.
What is Value-Based Care in Maternity?
Value-based care is an approach that focuses on the quality of care provided rather than the quantity. In maternity care, this means prioritizing outcomes that matter most to mothers and babies, rather than simply the number of procedures or visits.
The Health Care Transformation Task Force defines three levels of outcomes-driven maternity payment models:
Perinatal fee schedule changes
Value-based maternity payments
Comprehensive payments for mother and newborn
These models aim to align financial incentives with high-quality, evidence-based care throughout the perinatal period, including the often-overlooked postpartum phase.
The Need for Change
The United States faces significant challenges in maternal health outcomes:
Maternal mortality rates have more than doubled in the past three decades
Racial disparities persist, with Black women 3-4 times more likely to die from pregnancy-related causes than white women
Over 60% of pregnancy-related deaths are preventable
More than 50% of pregnancy-related deaths occur postpartum
These statistics underscore the urgent need for a new approach to maternity care, particularly in the postpartum period.
How Value-Based Care is Transforming Postpartum Care
Value-based care models are reshaping postpartum care in several key ways:
1. Extended Care Period
Traditional postpartum care often ends at the 6-week check-up. Value-based models, like Materna Health's 12-week Virtual Intensive Postpartum Care (IPC) program, recognize that postpartum needs extend well beyond this arbitrary cutoff.
2. Comprehensive Care
Value-based models emphasize holistic care that addresses physical recovery, mental health, breastfeeding support, and chronic condition management. This comprehensive approach can lead to better outcomes and higher patient satisfaction.
3. Proactive and Preventive Care
Instead of waiting for complications to arise, value-based models focus on prevention and early intervention. This can help reduce costly emergency room visits and hospital readmissions.
4. Personalized Care Plans
Value-based care recognizes that each mother's needs are unique. Programs like Materna Health's IPC offer personalized care plans that evolve as the mother's needs change over time.
5. Integrated Care Teams
Value-based models often involve multidisciplinary care teams, including OB/GYNs, midwives, lactation consultants, and mental health professionals. This team-based approach ensures comprehensive support for new mothers.
Benefits of Value-Based Maternity Care
The shift to value-based care in maternity offers benefits for all stakeholders:
For Mothers:
Improved health outcomes
Better support for physical and mental health needs
Enhanced patient experience
Reduced out-of-pocket costs
For Healthcare Providers:
Alignment of payment with quality of care
Opportunity to focus on preventive care
Potential for improved patient outcomes and satisfaction
For Health Plans:
Potential for cost savings through reduced complications and readmissions
Improved member satisfaction and retention
Alignment with broader value-based care initiatives
Challenges and Opportunities
While the potential benefits of value-based maternity care are significant, implementation can be challenging. Some barriers include:
Administrative complexity in changing payment models
Need for robust data collection and analysis
Resistance to change in established care practices
However, early adopters are showing promising results. For example, the Arkansas Health Care Payment Improvement Initiative saw a 3.8% reduction in overall perinatal spending in its first year of implementing an episode-based payment model for perinatal care.
The Future of Postpartum Care
As we move towards value-based care in maternity, we can expect to see continued innovation in postpartum care delivery. Virtual care models, like Materna Health's IPC program, are at the forefront of this transformation, offering extended, comprehensive care that aligns perfectly with value-based principles.
By focusing on outcomes that matter most to mothers and babies, value-based maternity care has the potential to dramatically improve the postpartum experience. As this approach becomes more widespread, we can hope to see better health outcomes, reduced disparities, and a more supportive transition to motherhood for all women.
