Using Value-Based Care to Tackle Maternal Health Disparities

February 25, 2020 - Priority Health, the second largest health plan in the state of Michigan, will financially offset the cost to providers who use the Centering Healthcare Institute’s (CHI) CenteringPregnancy value-based care model in an effort to combat prominent racially-driven maternal care disparities.

“Supporting a care model that not only improves health outcomes for members but also lowers overall health costs is a win-win. We are proud to offer this new incentive to providers who transition to the CenteringPregnancy care model,” said Marti Lolli, chief marketing officer and senior vice president of consumer and government markets at Priority Health. 

The payer will offer financial incentives to provider groups in certain regions, including OBGYNs and community health organizations. These providers will commit to using a centering model of care when working with their maternal groups.

CenteringPregnancy connects groups of women who are around the same stage of pregnancy to conduct prenatal care as a group. Through peer support, these groups help improve patient outcomes and increase patient satisfaction.

Women are more likely to stick with their prenatal routine when they are doing it in concert with their peers, much like the effect of peer recovery programs on medication adherence for substance abuse care.

Priority Health’s decision to invest in CenteringPregnancy was evidence-based. Previous studies, such as one conducted through the South Carolina Medicaid program in 2016, have shown that, at least in certain environments, CenteringPregnancy could decrease premature births and save millions of dollars. 

Furthermore, this method can be used to strengthen the relationship between the payer and provider.

“The costs of providing CenteringPregnancy are borne by the obstetric provider, but the savings accrue to payers,” said the researchers of the 2016 study. “This represents a unique opportunity for partnership between obstetric care providers and third-party payers and is emblematic of the paradigm shift which is occurring in the broader health care field.”

The researchers indicated that this model lends itself to value-based care and patient-centered care methods.

“Michigan Centering sites have also seen reduction in the disparity gap in preterm birth rates between Black and white women, increases in breastfeeding rates, and improved visit adherence & patient satisfaction,” the Priority Health press release attested. “By incentivizing Centering visits, Priority Health is recognizing the investment required by providers to transform care delivery from an individual to a group care model.”

For this reason, Priority Health provides this model to Medicaid members for free. Its Medicaid program receives high marks on the National Committee for Quality Assurance (NCQA) star ratings.

Other payers have funded research on using technology to decrease the maternal mortality rate in areas with rural healthcare challenges. Studies have also shown that stable health insurance plays a role in patient outcomes for new mothers.

However, Michigan is in particular need of a program like CenteringPregnancy. 

The Great Lakes State faces a monumental infant and maternal health crisis, ranking 32nd in infant mortality nationwide in America’s Health Rankings of 2018.

In the state’s 2020-2023 Mother Infant Health and Equity Improvement Plan, announced in 2019, research showed that the overall infant mortality rate was 6.8 infant deaths per 1,000 live births, as opposed to the national average of 5.8 deaths to 1,000 live births. Over 750 children did not live to see their first birthday in 2017 in Michigan.

Moreover, the infant mortality crisis in Michigan is racially charged. 

The same state improvement plan revealed that 2.8 black, non-Hispanic babies died for every white, non-Hispanic baby who died in 2017. A black, non-Hispanic child was also more than twice as likely to die before her first birthday compared to a white, non-Hispanic child. Native American babies also factor into this disparity, with a mortality rate of 9.4 for every 1,000 live births.

Infants are not the only ones at risk during pregnancy. Ninety women died either during pregnancy, while giving birth, or within a year of the end of their pregnancies in Michigan in 2015. And again, race plays an undeniable role, with black, non-Hispanic women being three times more likely to die from pregnancy-related issues than white Michiganders from 2011 to 2015.

By financially enabling providers to pursue CenteringPregnancy, Priority Health hopes to manage those care disparities and dire patient outcomes.

“We look forward to continuing our partnership with the Centering Healthcare Institute to help address racial health disparities within prenatal care here in Michigan,” added Lolli.