Costs – Charges – Value

From the TMC blog: CMS recommends Medicaid coverage of lactation services

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

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From the TMC blog: Guest Post: Lessons for Maternity Care from…Moneyball?

The movie Moneyball has been a recent box office hit, inspired by the true story of how Oakland Athletics General Manager Billy Beane went against baseball orthodoxy to create a winning baseball team. Facing baseball’s elite teams on a fraction of their budgets, Beane realized that the A’s couldn’t compete if they played the same old ballgame. When I saw the movie recently I was startled to see a considerable amount of thematic overlap with the issues currently facing maternity care.

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Filed in Blog, Costs - Charges - Value, Guest Posts on Wed., Nov 16, 2011

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From the TMC blog: Finding Common Ground on Home Birth

I attended the Home Birth Consensus Summit, along with our Director of Programs, Carol Sakala, late last week. The meeting was the result of several years of planning by a multi-stakeholder group of maternity care leaders. It was led by facilitators from Future Search, a theory and planning strategy designed around having the “whole system in the room” to find common ground on complex or divisive issues.

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems on Tue., Oct 25, 2011

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From the TMC blog: Maternity Care Improvement: Will it Play in Peoria?

You’ve probably heard the phrase, “Will it play in Peoria?” It originated in the early ’20s and ’30s during the US vaudeville era, when Peoria, IL was a popular stop for vaudeville acts and performances. If a show was well received in Peoria, it was likely to work throughout the country. Peoria has since become a well-known test market to gauge the popularity of products and ideas nationwide.

So what does this have to do with maternity care? Well, in this case, what’s playing in Peoria goes way beyond products and ideas to a full-blown actionable healthcare quality improvement project called “Healthy Babies, Healthy Moms.”

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, Quality Collaboratives on Wed., Sep 14, 2011

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From the TMC blog: Reasonable Choices for Bringing Back VBAC

As we shift the conversation from whether to do VBACs to how to enable more of them, focus on quality and safety in the context of VBAC is long overdue. According to new government statistics, nearly one in five of the more than 4 million births each year in the United States occur to women who have previously given birth by cesarean. If evidence supports VBAC as a “reasonable option” for most of this population and indeed the better option for many, it is time to be reasonable about how to make VBAC as safe, accessible, and satisfying as it can possibly be.

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, New Reports and Resources on Mon., Sep 12, 2011

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From the TMC blog: Four Maternity Care Trends to Watch

There’s a big gap between our current maternity care system and the high-quality, high-value system envisioned by a multi-stakeholder Transforming Maternity Care Project Team. We’re glad to see many of the recommendations put forth in the Blueprint for Action garnering broader interest and gaining momentum. Here are four we expect to play a growing role in system transformation over the coming months and years.

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Filed in Blog, Costs - Charges - Value, Hospitals and Health Systems, Quality Collaboratives on Mon., Aug 15, 2011

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From the TMC blog: Speed-dating and shared decision making: Transforming how women and maternity caregivers communicate

A recent New York Times article described a new method medical schools are adopting to interview applicants. Described as “the admissions equivalent of speed dating,” the Multiple Mini Interview process is designed to identify applicants adept at communication and teamwork. Why? Because effective communication and a teamwork approach are critical ingredients of a health care system that is safer, more patient-centered, and more efficient.

Speed dating for a spot in medical or nursing school, along with other innovations in health professions education, will hopefully generate a more effective workforce in the coming years. But for maternity caregivers already in practice, what are the best resources to improve communication skills?

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Filed in Blog, Clinicians, Costs - Charges - Value, New Reports and Resources on Tue., Aug 9, 2011

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From the TMC blog: Will Obstetricians Heed a Leader’s Warning to “Stop the Relentless Rise in Cesarean Deliveries?”

Kudos to Dr. John Queenan for his candid editorial “How to Stop the Relentless Rise in Cesarean Deliveries,” published in the August issue of Obstetrics and Gynecology. We applaud his candor as an obstetric leader willing to confront the serious problems associated with the steadily rising cesarean section rate now approaching 34%.

Dr. Queenan predicts that the significant increase in primary cesareans coupled with the sharp decrease in the VBAC rate will soon result in a 50% cesarean section rate in the U.S.

There’s no doubt that the relentless rise has been a source of anxiety for maternity care stakeholders for at least a decade as the rate has increased year after year. Women feel pressure to accept interventions including major surgery they’re not sure they’ll benefit from, driving a small but rapidly growing group of women to opt for home birth instead. Medicaid programs face severe financial constraints and are set to accept millions of new enrollees in 2014. Given the price tag, Medicaid simply can’t afford a 50% cesarean rate, nor even to sustain the current rate. Obstetricians are now seeing more and more patients with sometimes life-threatening consequences of too many c-sections at unprecedented rates. As Dr. Queenan warns, “the rising cesarean rate is a threat to the profession and there’s no time for complacency.” His editorial ends with a clarion call for concerted action by his profession to confront the problem and commit to action before policy-makers and payers step in and force change.

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Filed in Blog, Clinicians, Costs - Charges - Value, Hospitals and Health Systems, Leadership on Tue., Aug 2, 2011

From the TMC blog: Charges for giving birth are all over the map. What’s the price tag in your state?

If you give birth in a Maryland hospital, your hospital will charge about $5500 if you have an uncomplicated vaginal birth and about $6800 if you have an uncomplicated cesarean section. Move just up the coast to New Jersey and triple or even quadruple those numbers. The hospital now charges more than $18,000 for the same vaginal birth and a whopping $26,000 for the same cesarean. Move to a state with a birth center, like California or Washington, and the facility charge drops to as low as $2000 for an uncomplicated vaginal birth.

How does your state measure up? Childbirth Connection has just posted Average Facility Labor and Birth Charges by Site and Method of Birth for the 35 states for which data are available.

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Filed in Blog, Costs - Charges - Value on Thu., Jul 14, 2011

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