Catalyst for Payment Reform

Toolkit: Building a High-Value Maternity Network

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As the leading cause of hospitalization in the United States, childbirth comprises a significant portion of health care spending for employers and other health care purchasers.[1],[2] The uneven quality of maternity care at the hospital and provider level reveals an opportunity for purchasers to identify local high-quality, lower-cost maternity care providers by developing a high-value maternity network: a market-based solution that curates a network of high-performing hospitals and their associated providers, and spurs them to compete on quality and cost.

The Building a High-Value Maternity Network Toolkit gives employers and other health care purchasers the resources and guidance needed to develop a network of high-quality, affordable maternity providers who are committed to patient-centered care and health equity. When paired with benefit design strategies and an effective communications campaign, this strategy can reduce a purchaser’s costs and improve the quality of care that plan participants receive. Moreover, it can create in-roads between purchaser and providers, paving avenues for continuous collaboration and progress toward greater safety, affordability, and patient satisfaction.

This toolkit includes

  • Toolkit Overview: This document provides an introduction to the Toolkit, an overview of the biggest pain points in maternity care in the United States, and a summary for each of the toolkit resources – including how each one can be applied outside of a HVMN strategy.
  • Case Study: The 32BJ Health Fund: This case study documents the 32BJ Health Fund’s process for developing and implementing a high-value maternity network in New York City and Northern New Jersey.
  • Request for Information (RFI) Template: This customizable template provides purchasers with a set of evidence-based questions that can be presented to hospitals and health systems in order to evaluate and identify a high-value maternity network.
  • RFI How to Guide: As an accompaniment to the RFI, the How to Guide offers step by step instructions to help purchasers navigate the RFI process.
  • Provider Outreach Communication Template: This customizable template offers messaging that articulates the benefit to providers of entering into clinical partnership through a high-value maternity network.  Purchasers can use this tool as a template for outreach to candidate hospitals and health systems.
  • Maternity Baseline Assessment Tool: This tool highlights the quality, cost, and utilization measures that purchasers will want to analyze to assess the baseline status of maternity care. It includes an embedded Excel Spreadsheet that allows purchasers to compare the differences in frequency of C-section and maternal morbidity across various demographic groups within their population.
  • Hospital Contracting Options: This tool provides purchasers with an overview of the effectiveness of the most prominent payment reform models in maternity care: pay for performance, blended payment for C-sections and vaginal deliveries, nonpayment for medically unnecessary early elective deliveries, and bundled payment.
  • Benefit Design Options: The benefit design options tool offers discourse on the types of incentives purchasers can deploy to influence plan participants’ choices and behaviors. These include financial incentives for using preferred maternity care providers, incentives for program adherence (particularly for pre-natal care), and coverage for non-traditional providers and programs.

[1] Health Care Cost Institute. (2020). 2018 Health Care Cost and Utilization Report. Retrieved from https://healthcostinstitute.org/images/pdfs/HCCI_2018_Health_Care_Cost_and_Utilization_Report.pdf

[2] National Partnership for Women and Children. (2020). Maternity Care in the United States: We Can – and Must – Do Better. https://www.nationalpartnership.org/our-work/resources/health-care/maternity-care-in-the-united.pdf

Type: Toolkit

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