The March of Dimes is leading a new council seeking to ensure better health for women and babies nationwide by accelerating the adoption of the group model of prenatal care during pregnancy.
Organizations representing the nation’s obstetricians, newborn and obstetric nurses, midwives, health plans and public health experts have come together to form the National Council on Financing Group Prenatal Care. The council will review the current state of financing for group prenatal care, address the barriers to more widespread use of this model and examine potential financing solutions, both tested and untested. It will engage leaders of federal and state agencies, health plans, health organizations, health systems and others in the process.
Members of the Steering Committee include the American Congress of Obstetricians and Gynecologists (ACOG), American College of Nurse-Midwives (ACNM), Association of State and Territorial Health Officials (ASTHO), Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN), Health Resources and Services Administration (HRSA), Centering Healthcare Institute (CHI), National Association of Medicaid Directors (NAMD), Brown University, and UnitedHealth Group.
In addition, Aetna, Cigna, Anthem Inc., Centers for Disease Control and Prevention (CDC), Yale University, WellCare Health Plans, Greenville Health System, National Business Group on Health, and the Tennessee Department of Health are also engaged in the council.
Group prenatal care is an evidence-based model that brings together a small group of pregnant women (10-12) with similar due dates for prenatal care with their obstetric care provider. During group sessions, women receive a brief physical assessment (in a semi-private setting), share support with each other, and gain knowledge and skills related to pregnancy, birth, infant care and parenting. Group prenatal care has gained momentum in recent years, and published data show that among its benefits are reductions in preterm birth and rapid repeat pregnancy; improvement in readiness for labor and delivery; and patient and health care provider satisfaction.
“We need to take a holistic approach to preventing premature birth, the leading cause of death among babies in the United States and a significant cause of lifelong disabilities,” said Dr. Jennifer L. Howse, president of the March of Dimes. “The March of Dimes thinks group prenatal care is part of the future of better health for moms and babies. We’ve convened this National Council on Financing to find ways to make group prenatal care available to all pregnant women, regardless of their insurance status, and to make it more financially viable for health systems and health care providers.”
“Currently, group prenatal care can result in higher costs for obstetric practices while generating large savings for payers and employers,” said ACOG Vice President of Health Policy Barbara S. Levy, M.D. “In order to make group prenatal care more sustainable, we need to find ways to help ob-gyns and other maternity care providers make the needed investments to deliver this model of care and share in the savings generated.”
The Toll of Preterm Births in the United States
In 2015, 9.6 percent of all births in the U.S. were preterm (born before 37 weeks of pregnancy). The March of Dimes’ goal is to reduce the nation’s preterm birth rate to 8.1 percent by 2020 and then to 5.5 percent by 2030.
Babies who survive an early birth often have lifelong health issues such as cerebral palsy, vision and hearing loss, and intellectual disabilities. Even babies born just a few weeks early have a greater risk of respiratory distress syndrome (RDS), feeding difficulties, temperature instability (hypothermia), jaundice, and delayed brain development.
Several research studies funded by the National Institutes of Health and Centers for Medicare & Medicaid Services found that a group setting for prenatal care is associated with fewer preterm births, reduced incidence of low birth-weight infants, and lower likelihood of a stay in the newborn intensive care unit (NICU).1, 2
The economic costs of preterm births reached $26.2 billion in 2006 – the most recent data available from the National Academy of Medicine (formerly Institute of Medicine) – accounting for more than one-third of all U.S. health care spending for infants. A premature birth costs employers about 10 times more than a healthy, full-term birth in the first year of life ($55,393 vs. $5,085), according to a 2014 analysis by Truven Health Analytics commissioned by the March of Dimes.
The potential net savings to federal and state governments through the Medicaid program, which covers roughly half of all births, over a five-year period would equal about $12 billion if half the pregnant women enrolled in Medicaid were to receive care through a group model, according to an analysis by the UnitedHealth Center for Health Reform & Modernization.3
For many years, the March of Dimes has been in collaboration with CHI to support the CenteringPregnancy® model, and has been funded in part by the Anthem Foundation to expand this model. The March of Dimes plans to continue the expansion of group prenatal care with CHI and by developing its own new group prenatal care program, March of Dimes Supportive Pregnancy Care.
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References:
1Jeannette R. Ickovics, Trace S. Kershaw, Claire Westdahl, Sharon Schindler Rising,Carrie Klima, Heather Reynolds, and Urania Magriples. Group Prenatal Care and Preterm Birth Weight: Results from a Matched Cohort Study at Public Clinics. Obstet Gynecol. 2003 Nov;102(5 Pt 1):1051-7.
2 Sarah Gareau, Ana Lòpez-De Fede, Brandon L. Loudermilk, Tammy H. Cummings, James W. Hardin, Amy H. Picklesimer, Elizabeth Crouch, et al. Group Prenatal Care Results in Medicaid Savings with Better Outcomes: A Propensity Score Analysis of CenteringPregnancy Participation in South Carolina. Matern Child Health J. 2016 Jul;20(7):1384-93. doi: 10.1007/s10995-016-1935-y
3 100 Percent of Our Future: Improving the Health of America’s Children, UnitedHealth Center for Health Reform & Modernization, August 2013.