Payment Reform to Align Incentives with Quality

The United States spends far more than all other countries on health care, yet lags behind many on fundamental maternal and newborn indicators. The current maternity care payment system creates incentives for overuse of some practices and underuse of others. These are poorly aligned with quality and value and increase costs without improving health outcomes. Reforming payment systems has the potential to improve practice, reduce morbidity, and save lives of mothers and babies, while simultaneously improving value.

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Major Recommendations

  1. Advance efforts toward comprehensive payment reform through a restructured payment model that bundles payment for the full episode of maternity care for women and newborns.
  2. Pilot model payment reform strategies through regional demonstration projects funded through competitive Request for Funding Proposals, and disseminate successful strategies for replication and widespread uptake.
  3. While working toward comprehensive payment reform, implement selected policies immediately to address some severe misalignments in the current payment system.
  4. Develop critical enabling factors and conditions for payment reform in concert with payment reform efforts.

Learn more about the ACTION STEPS for implementing these recommendations. >>

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