Payment reform

In the Literature: At Intermountain, process improvement reduces inductions, cesareans, NICU admissions, and costs

As a result of process improvement efforts bolstered by robust information systems, the proportion of all inductions that lacked strong indications for clinical appropriateness fell from 28 percent to less than 2 percent. The project also resulted in decreases in both NICU admissions and cesareans, and Intermountain estimates that the elective induction protocol reduces health care costs in Utah by $50 million per year.

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Filed in Blueprint, Clinical audit, case review, or analysis of adverse events, Clinical controversies, Clinical practice guideline/policy change, Health information technology, Health information technology, In the Literature, Payment reform, Performance measurement, Performance measurement/reporting on Fri., Jul 29, 2011

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State Legislative Action: A Bill to Reduce Early Births, Costs in Minnesota

This legislation would alter the organization of and payment for maternity services by: creating a mechanism to deny Medicaid payment for elective deliveries before 39 weeks, bundling payment for the full episode of maternity care for low-risk women, enabling access to midwives and birth centers providing high-quality, high-value care, and developing standards and a certification process for “pregnancy care homes”

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Filed in Care coordination, Clinical controversies, New care delivery model, Payment reform, Payment/reimbursement change, Scope of covered services, Staffing/care coordination change, State Legislation, Workforce on Tue., Apr 26, 2011

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From the Field: Louisiana Birth Outcomes Project

The Louisiana Birth Outcomes Project is a state-wide effort coordinated by the Department of Health and Hospitals. This multi-stakeholder initiative drew inspiration from the Transforming Maternity Care project and charged several interdisciplinary task forces with constituencies modeled after the five TMC stakeholder workgroups to determine critical steps for progress in four major areas: quality and safety, interconception care, behavioral health, and performance measurement.

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Filed in Blueprint, Care coordination, Childbirth Connection, Clinical controversies, Clinical practice guideline/policy change, Community education/outreach, Disparities, Health information technology, Health information technology, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Scope of covered services, Staffing/care coordination change, Stories from the Field on Fri., Apr 22, 2011

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Federal Legislative Action: Partnering to Improve Maternity Care Quality Act of 2010

This act addresses many of the recommendations put forth in the direction-setting Blueprint for Action, with provisions related to many of the Blueprint’s 11 focal areas, including performance measurement and leveraging of results; payment reform aligning incentives with quality; scope of covered services for maternity care; coordination of maternity care across time, settings, and disciplines; decision-making and consumer choice; and development and use of health information technology.

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Filed in Care coordination, Childbirth Connection, Decision making and choice, Federal Legislation, Health information technology, Health information technology, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Scope of covered services on Mon., Apr 4, 2011

From the Field: Washington State Perinatal Collaborative Reducing Elective Delivery Before 39 Weeks Project

The collaborative is seeking to understand the reason for rising C-Section rates and possible modifiable factors leading to this rise. The collaborative believes that the variation among hospitals in cesarean, VBAC, and induction rates are affecting maternal and infant health across the state of Washington. To address these variations the collaborative is engaging agencies, hospitals, organizations, and the community to encourage birthing hospitals to collaborate and address issues such as inductions, trial of labor, appropriate admissions, and accessibility to vaginal births after cesareans. The first initiative uses the March of Dimes Toolkit and other resources to reduce early elective deliveries in the state of Washington.

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Filed in Clinical practice guideline/policy change, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Stories from the Field on Fri., Mar 18, 2011

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Leading employers launch bold payment reform initiative

Late last year, TMC Vision Team and Partnership Steering Committee member Suzanne Delbanco, PhD, was named Executive Director of Catalyst for Payment Reform, a collaboration among seven of the nation’s largest employers using their purchasing power to advocate for health care payment approaches that reduce costs and waste while spurring higher quality.

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Filed in Blueprint, News, Payment reform on Sun., Mar 6, 2011

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