UnitedHealthcare is launching a new bundled payment program for maternity care to support full-term births and lower the number of cesarean deliveries for low-risk pregnancies.
Bundled payment programs link reimbursement to the delivery of coordinated care for better outcomes and reduced costs.
The maternity model will reimburse a provider for a defined episode of care, such as prenatal, delivery and postpartum services, under a single fee or payment. It encourages providers to close gaps in care to reduce the risk of complications before and after delivery,
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The program launched with two healthcare providers, Lifeline Medical Associates in New Jersey and Privia Medical Group – Gulf Coast in Texas, for expectant mothers enrolled in UnitedHealthcare employer-sponsored health plans.
The maternity bundled payment program will roll out to cities across the country during the coming months, expanding to as many as 20 providers by the end of 2019.
Mothers enrolled in UnitedHealthcare employer-sponsored plans will have access to the program at no additional cost and employers can offer these resources to their employees.
The efforts are all aimed at improving the U.S. infant and maternal mortality rates, which rank lower than those of many other developed nations, including Australia, Canada and Lithuania, the insurer said.
It also has the goal to reduce the number of C-section births. The federal government has set a 23.9 percent target, which UnitedHealthcare said it has surpassed. The C-section rate for low-risk pregnancies among women enrolled in its employer-sponsored health plans in 2018 was 18 percent.
Approximately one-third of babies nationwide are born via C-section, according to the Centers for Disease Control and Prevention. The percentage of C-section births has grown over the decades. The World Health Organization considers a normal range to be 10-15 percent for healthy women with low-risk pregnancies to undergo a C-section.
Studies have shown that early, non-medically indicated C-sections are linked to a higher risk of complications, including infection, hemorrhage or blood clots, and admission to the newborn intensive care unit.
C-sections also generally cost more, though a recent study has shown that while inducing labor is never recommended unless there is a health-related medical need, the cost of inducing labor at 39 weeks is the same as waiting for spontaneous labor at around 40 weeks.
WHAT ELSE YOU NEED TO KNOW
The bundled payment model builds on UnitedHealthcare's maternity program, which the insurer said has contributed to fewer non-medically indicated C-section deliveries, reduced both pre-delivery hospital admissions and the average length of stay in the newborn intensive care unit and decreased other delivery and newborn-related costs.
UnitedHealthcare's maternity program includes a mobile app for expectant women that has personalized content and around-the-clock nurse support. Nurses can help manage chronic conditions and connect pregnant women with behavioral healthcare for emotional and mental support.
The app also allows expectant mothers to monitor weight; set reminders to take vitamins; track appointments; take a health assessment and discuss the results with a nurse; receive customized weekly updates based on the baby's gestational age; search for information about pregnancy symptoms and concerns; and use a "kick counter" to track the baby's movements.
It allows access to healthcare cost estimates and plan benefit information.
These resources are provided in collaboration with Optum, UnitedHealth Group's health services business.
The maternity program was developed in collaboration with the U.S. Women's Health Alliance, a national organization of leading healthcare practices. Expansion of the program will include providers affiliated with the U.S. Women's Health Alliance.
By the end of 2020, the company said expects to have $75 billion in care provider reimbursements tied to value-based arrangements.
ON THE RECORD
"These resources can help improve access to quality, coordinated care, offering important support to women and families before, during and after delivery," said Dr. Janice Huckaby, who leads UnitedHealthcare's women's health initiatives as a senior vice president and regional chief medical officer. "Value-based care programs such as this help improve clinical quality, patient safety and satisfaction, and care coordination among physicians, with the goal of reducing costs."
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