Supporting Payment for CenteringPregnancy
While all providers are reimbursed for the patient encounter that occurs are part of a CenteringPregnancy session, not all are reimbursed for the related costs and time associated with providing group prenatal care. We seek to build upon the success in thirteen states where substantial progress has been made toward payment for group prenatal care through Medicaid-managed care organizations or a model that pays for group prenatal care in excess of individual prenatal care. As of 2021, there are five state Medicaid programs and 14 health plans that participate in payment strategies for CenteringPregnancy. CHI tracks these and other efforts to establish payment for group prenatal care through value-based payment such as alternative payment models (APMs), enhanced reimbursement and other funding mechanisms including grants and one-time funding streams. The following resources provide insight into the efficacy of payment for group prenatal care to improve birth and maternal health outcomes, promote satisfaction with the care experience by birthing people and healthcare providers and reduce racial disparities.
Advocacy & Policy Resources
Aligning Value-Based Payment with CenteringPregnancy
In this independently prepared whitepaper by Health Management Associates, evidence suggests CenteringPregnancy reduces costs, improves outcomes and leads to high satisfaction. This holistic model can be sustainably financed along the continuum of value-based payment using a variety of approaches. In Medicaid, the largest payer for maternity care, states have the opportunity to offer CenteringPregnancy to more women as part of their emerging payment and delivery system reforms.
Prenatal-to-3 State Policy Roadmap 2020: Building a Strong and Equitable Prenatal-to-3 System of Care
A comprehensive analysis from the Prenatal-to-3 Policy Impact Center of policies and tactics to increase access to critical services for mothers and babies and reduce racial disparities, including financial support for the implementation of group prenatal care through enhanced reimbursements for group prenatal care providers.
Medicaid Payment Initiatives to Improve Maternal and Birth Outcomes
An issue brief from the Medicaid and CHIP Payment and Access Commission (MACPAC) explores how state Medicaid programs use payment incentives to positively impact maternal and birth outcomes, including bundled payments, blended payments for delivery, pay for performance and medical homes.
Accelerating and Aligning Clinical Episode Payment Models
Chapter four of Accelerating and Aligning Clinical Episode Payment Models from the Health Care Payment Learning & Action Network seeks to help speed the adoption of alternative payment models (APMs) for maternity care, including design and implementation of clinical episodes.