You can get from New Jersey to Maryland in less than an hour, but despite the proximity, New Jersey hospitals, on average, charge 3-4 times more than Maryland hospitals for both vaginal and cesarean births. This is just one of the notable facts gleaned from Childbirth Connection’s analyses of the latest maternity charges data. Although the data do not show whether higher charges reflect better care, researchers who look at price variation generally find no relation between prices and the quality of care, complexity of patient care needs, or costs of actually delivering care. Such unwarranted price variation amounts to billions in wasted spending across the health care system, according to a February report from Thomson Reuters that looked at various hospital procedures.
New charts compiled by Childbirth Connection (PDF) show the significant price variation across states that report average labor and birth hospital charges to the Healthcare Cost and Utilization Project (HCUP). The chart set also includes average prices charged by birth centers, which fall well below charges for uncomplicated vaginal births in hospitals. State-by-state analyses (PDF) show charges increasing year-to-year, and reveal differences by mode of birth and presence or absence of complications.
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Filed in Blog, Costs - Charges - Value on Wed., May 9, 2012
At Childbirth Connection, we know that performance measurement is an essential element for moving toward the maternity care system that women and families deserve — one that meets the Triple Aim of better care, better outcomes, and better value. Performance measurement is central to our 2020 Vision for a High-Quality, High-Value Maternity Care System and companion Blueprint for Action consensus reports. So, we are thrilled that the National Quality Forum (NQF) has approved for endorsement 12 continuing and 2 new maternity care performance measures.
Pending a 30-day appeal period, these will continue to be available or be newly available as nationally endorsed performance measures for both quality improvement and public reporting. I am pleased to offer this update as co-chair of the multi-stakeholder Steering Committee that evaluated measures submitted by developers within the formal NQF consensus development process with explicit criteria for endorsement.
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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, New Reports and Resources, Quality Collaboratives on Wed., Apr 11, 2012
On March 31, the eve of Cesarean Awareness Month, the National Health Policy Forum addressed the rising rate of cesarean section in the United States. The Forum is a non-partisan organization that offers educational programming and other health policy resources to congressional and federal agency staff.
Caesar’s Ghost: The Effect of the Rising Rate of C-Sections on Health Care Costs and Quality, explored the drivers and consequences of the increasing c-section rate and public- and private-sector initiatives to achieve a more optimal rate. Forum presenters included:
- Maureen Corry, who presented results of Childbirth Connection’s Cesarean Evidence Project and the Listening to Mothers surveys and shared recent national data on cesarean and VBAC rates, average hospital charges for cesarean and vaginal births, and cost comparisons across industrialized countries. Her presentation also reviewed progress on key recommendations from the TMC Blueprint for Action.
- Jeff Thompson, MD, Chief Medical Officer for the Washington State Medicaid Program, who presented about the state’s multiple strategies to reduce cesarean section. These include licensing and reimbursing fees for birth centers and Certified Professional Midwives and testing payment reforms to penalize early elective deliveries and incentivize VBAC.
- Andréa Caballero Dilweg, from Catalyst for Payment Reform (CPR), who shared purchaser strategies from CPR’s Payment Reform Toolkit and Maternity Care Special Initiative.
- Frank Mazza, MD, Chief Patient Safety Officer at Seton Healthcare Family in Austin, TX, who discussed Seton’s award-winning perinatal safety program that reduced birth injuries, instrumental vaginal deliveries, and NICU admissions without increasing the use of c-section.
Filed in Blog, Clinicians, Costs - Charges - Value, Hospitals and Health Systems on Tue., Apr 3, 2012
Earlier this year, the Center for Medicare and Medicaid Innovation (CMMI) announced Strong Start, a major federal initiative to improve birth outcomes among Medicaid enrollees. (Letters of Intent are now due May 11, 2012.) The initiative includes a funding opportunity for three innovative models of prenatal care delivery that show promise for reducing preterm births. Two of the three models have national organizations that define and promote them: group prenatal care models like CenteringPregnancy and prenatal care in birth centers, a model promoted by the American Association of Birth Centers. The third model has left some people scratching their heads: Maternity Care Homes. What is a Maternity Care Home and, more importantly, what changes do practices have to make to become one?
The purpose of this article is to foster awareness and discussion about Maternity Care Homes and to encourage Strong Start applicants to advance this model. The article will answer common questions about Maternity Care Homes, with an emphasis on implementation. If you have other questions, please leave them in the comments.
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Filed in Blog, Clinicians, Costs - Charges - Value, Funding Announcements, Hospitals and Health Systems on Wed., Mar 28, 2012
Our goal is to reduce the unnecessary induction and c-section rate in the US. This first project is meant to raise awareness and consciousness to the mainstream public. Our desire was for an event on such a mass scale that all major media outlets would pick up the story and continue to do stories both before and after the event.
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Filed in Clinical controversies, Community education/outreach, Decision making and choice, Progress, Stories from the Field on Wed., Mar 28, 2012
by Amy Romano 
by 