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
We are very pleased to join the Centers for Medicare and Medicaid (CMS) and several other public and private partners to launch Strong Start, an initiative to improve maternity care outcomes. Yesterday, Secretary of Health and Human Services, Kathleen Sebelius, announced the initiative at the Family Health and Birth Center in Washington, DC.
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Filed in Blog, Funding Announcements on Thu., Feb 9, 2012
Building a system that reliably provides Maternity Care with a Heart requires a lot of behind-the-scenes work. Childbirth Connection has just launched a fundraising campaign asking our supporters to pitch in $14 for Maternity Care With a Heart in Honor of Valentine’s Day. Your support will help us have the most impact at this time of unprecedented opportunity to make change. Here are 14 new and ongoing projects your donations will help support in 2012.
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Filed in Blog on Wed., Feb 8, 2012
One year ago, the Leapfrog Group released results of their annual Hospital Survey, for the first time publicly reporting rates of early elective deliveries (inductions or planned c-sections occurring before 39 weeks without a medical reason). The results were shocking, with hospitals varying from virtually zero to well over half of elective deliveries occurring before 39 completed weeks. Last week, we partnered again with the Leapfrog Group and other organizations to publicize the release of this year’s survey results, and we’re pleased that the data show rates moving in the right direction.
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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, New Reports and Resources on Tue., Jan 31, 2012
The Centers for Medicare and Medicaid Services has released an issue brief addressing Medicaid coverage of lactation services. It recommends:
Due to the multiple health benefits associated with breastfeeding, CMS encourages States to go beyond the requirement of solely coordinating and referring enrollees to the Special Supplemental Food Program for Women, Infants, and Children (WIC)…and include lactation services as separately reimbursed pregnancy-related services.
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Filed in Blog, Costs - Charges - Value on Fri., Jan 13, 2012
We convened the Transforming Maternity Care (TMC) Project because we believed that transformation is possible, and rapid gains in maternity care quality and value are within our reach. While there’s much work still to be done, we look back at the past year and recognize that the transformation is well underway!
We bring you our year-end list of 11 signs that maternity care is transforming. We are proud of Childbirth Connection’s contributions to many of these, and want to thank our TMC Partners and all stakeholders leading the way to better maternity care.
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Filed in Blog on Tue., Dec 20, 2011
Our Leading Change series profiles leaders in efforts to transform maternity care. This month we bring readers an interview with Christine Morton, PhD, a medical sociologist at the California Maternal Quality Care Collaborative. Christine and I discuss the rising rate of maternal mortality, how standardizing care for obstetric hemorrhage can help, the need for better data collection and reporting, and how state quality collaboratives can lead change. Thanks Christine for taking the time to answer these questions, and thanks everyone at CMQCC for your work to transform maternity care!
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Filed in Blog, Clinicians, Consumers, Hospitals and Health Systems, Interviews, Leading Change, New Reports and Resources, Quality Collaboratives on Thu., Dec 15, 2011
by Amy Romano 
by 