- Bundled payment program has launched
with care providers in New Jersey and Texas, with plans to expand
to as many as 20 care provider groups by year-end 2019
- Developed in collaboration with the
U.S. Women’s Health Alliance, the program will be expanded to
additional care provider groups that deliver quality, efficient
care
- Payment model builds upon existing
maternity care program that has helped reduce the cesarean delivery
rate for low-risk pregnancies across UnitedHealthcare’s
employer-sponsored health plans to below national
targets1
UnitedHealthcare, a UnitedHealth Group (NYSE: UNH) company, has
introduced a new bundled payment program for maternity care to help
support the well-being of moms and babies before and after delivery
by closing gaps in care and encouraging healthy, full-term
pregnancies.
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Here are facts and tips to consider
related to women's health and childbirth, including information to
help encourage healthy, full-term deliveries (Source:
UnitedHealthcare).
The new bundled payment program for maternity care has launched
with two health care providers, Lifeline Medical Associates in New
Jersey and Privia Medical Group – Gulf Coast in Texas, to help
encourage more coordinated care and better health outcomes for
expectant mothers enrolled in UnitedHealthcare employer-sponsored
health plans. By year-end 2019, UnitedHealthcare will expand the
bundled payment program to as many as 20 care provider groups,
including ones affiliated with the U.S. Women’s Health Alliance, a
national organization of leading health care practices.
The payment model builds on the UnitedHealthcare Maternity
program*, which has helped women by contributing to fewer
non-medically indicated cesarean (C-section) deliveries, reduced
both pre-delivery hospital admissions and the average length of
stay in the neonatal intensive care unit (NICU), and decreased
other delivery and newborn-related costs.2 The C-section rate for
low-risk pregnancies among women enrolled in UnitedHealthcare’s
employer-sponsored health plans in 2018 was 18 percent,1 lower than
the 23.9 percent target set by the federal government.3
Approximately one-third of babies nationwide are born via
C-section, according to the Centers for Disease Control and
Prevention (CDC). Studies have shown that early, non-medically
indicated C-sections are linked to a higher risk of complications,
including infection, hemorrhage or blood clots, and admission to
the NICU.4
For a first-hand account of how UnitedHealthcare’s maternity
resources helped support a healthy, full-term delivery for a new
mom, click here.
“These resources can help improve access to quality, coordinated
care, offering important support to women and families before,
during and after delivery,” said Janice Huckaby, M.D., who leads
UnitedHealthcare’s women’s health initiatives as a senior vice
present and regional chief medical officer. “Value-based care
programs such as this help improve clinical quality, patient safety
and satisfaction, and care coordination among physicians, with the
goal of reducing costs.”
The bundled payment method reimburses a care provider or
hospital for a defined episode of care (EOC), such as prenatal,
delivery and postpartum services, under a single fee or payment.
This is a shift away from the common fee-for-service structure in
which a care provider is paid for each treatment, appointment or
test, generating multiple claims within a single, broader episode
of care. Bundled payment methods reward care providers for value
over volume, helping align incentives and linking reimbursement to
the delivery of coordinated, efficient care.
“The collaboration to develop and launch this maternity episode
of care program marks an important next step in our journey to
improve the quality and affordability of care for women across
America,” said Jack Feltz, M.D, president of the U.S. Women’s
Health Alliance. “This transformative program helps give care
providers the necessary resources to make a difference in improving
quality while decreasing costs.”
The UnitedHealthcare Healthy Pregnancy® mobile app** and
Maternity program provide expectant women with personalized content
and 24/7 nurse support. Nurses can coordinate care, help with the
management of chronic conditions, and connect pregnant women with
behavioral health care teams for emotional and mental health
support. These resources are provided in collaboration with Optum,
UnitedHealth Group’s health services business.
Eligible people can download the app onto their iPhone® and
Android® devices, enabling expectant parents to:
- connect with a registered nurse 24/7
for support and information;
- monitor and track weight, set reminders
to take vitamins and track appointments;
- take a health assessment and discuss
the results with a nurse;
- receive customized weekly updates based
on the baby’s gestational age;
- search for information about pregnancy
symptoms and concerns;
- use a “kick counter” to track the
baby’s movements; and
- access health care cost estimates and
plan benefit information.
Employers can offer these resources to their employees at no
additional cost as part of their benefit plan.**
The maternity care bundled payment program is part of
UnitedHealthcare’s ongoing commitment to value-based care. By the
end of 2020, the company expects to have $75 billion in care
provider reimbursements tied to value-based arrangements annually,
which support the health of UnitedHealthcare plan participants at
no additional charge.
“Bringing together industry stakeholders with the collective
vision to work together to improve care quality and affordability
will be crucial for modernizing the nation’s health care system,”
said Mark Cone, M.D., FACOG, market president, Privia Medical Group
– Gulf Coast. “On behalf of our doctors at Privia Medical Group, we
are excited to be a part of this collaborative effort.”
About
UnitedHealthcareUnitedHealthcare is dedicated to helping
people live healthier lives and making the health system work
better for everyone by simplifying the health care experience,
meeting consumer health and wellness needs, and sustaining trusted
relationships with care providers. In the United States,
UnitedHealthcare offers the full spectrum of health benefit
programs for individuals, employers, and Medicare and Medicaid
beneficiaries, and contracts directly with more than 1.2 million
physicians and care professionals, and 6,500 hospitals and other
care facilities nationwide. The company also provides health
benefits and delivers care to people through owned and operated
health care facilities in South America. UnitedHealthcare is one of
the businesses of UnitedHealth Group (NYSE: UNH), a diversified
health care company. For more information, visit UnitedHealthcare
at www.uhc.com or follow @UHC on Twitter.
All trademarks are property of their respective owners.
*The information provided under this program is for general
informational purposes only and is not intended to be nor should be
construed as medical and/or nutritional advice. Participants should
consult an appropriate health care professional to determine what
may be right for them. Employers are responsible for ensuring that
any wellness programs they offer to their employees comply with
applicable state and/or federal law, including, but not limited to,
GINA, ADA and HIPAA wellness regulations, which in many
circumstances contain maximum incentive threshold limits for all
wellness programs combined that are generally limited to 30 percent
of the cost of self-only coverage of the lowest-cost plan and
prohibitions on incentives to dependent children, as well as
obligations for employers to provide certain notices to their
employees. Employers should discuss these issues with their own
legal counsel.
**The UnitedHealthcare Healthy Pregnancy application is
available only to eligible participants enrolled in certain
employer-sponsored plans. Application registration is required.
1UnitedHealthcare Economics Women’s Health Outcomes Analysis,
20182Optum Healthcare Economics Maternity Program Analytics Study,
20183 Office of Disease Prevention and Health
Promotionhttps://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives4
The Journal of Maternal-Fetal & Neonatal Medicine,
2016https://www.tandfonline.com/doi/abs/10.3109/14767058.2015.1023187?src=recsys&journalCode=ijmf20
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Will ShanleyUnitedHealthcare(714)
204-8005will.shanley@uhc.com
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