INSURERS, PURCHASERS, and self insured employers CAN directly contract with birth centers to assure VaLUE BASEd quality care to employees.

Employers and consumers energize the marketplace by demanding real consequences in receiving care from high performance and value providers. Birth centers are an effective triple aim solution for maternity care in providing low cost effective quality care and high patient satisfaction, benefiting employers, insurers and consumers.

Freestanding Birthing Centers

Maternity is the highest admission for hospitalization, accounting for more than 3.9 million stays. Employers fund 47% of all babies born in the US and Medicaid finances nearly half of all deliveries. Maternity is also the highest cost per admission and has risen in costs yearly for the employer and employees’s cost sharing. Among rich westernized countries, the US pays the highest cost per patient in maternity care and the results are the poorest outcomes.

Freestanding birthing centers  (not a hospital or licensed as part of a hospital) are often overlooked as a viable alternative  for healthy women with low risk pregnancies due to lack of education by employers and employees to alternative options and access. Birth center outcomes are consistently better in reduced cesarean rates, fewer complications, decrease in preterm births and low birth weight babies, less NICU admissions, less ED visits, less re-admissions, higher rates of exclusive breastfeeding, and increased patient satisfaction. Birth centers are a better value for payers and families due to lower costs of childbirth in a recognized basic level of maternity facility.

In the past, health plans typically hadn't included birth centers in their provider networks unless members or clients requested. Reduced access restricts high value choices for mothers. Fair reimbursement to birth center facilities is 60-70% percent of the average commercial charges by hospitals in the regional area for the same services.

The ACA and Medicaid mandate coverage of birth centers and fees paid to certified nurse-midwives payable at one-hundred percent of physician reimbursement.  CMS has released rules of network sufficiency to mandate Medicaid Managed Care Organizations (MCO) include at least one birth center it is network as of July 1, 2017.  

Birth center outcomes reduces costs for insurance plans and purchasers of insurance by decreasing cesarean sections, preterm births, and NICU admissions. 

Employers and Purchasers who want a high value based proposition with low cost choices for pregnant women can improve access to birth centers by telling their health plans that they expect birth centers and midwives to be included in their provider networks and paid fair rates. Employers need to know that birth centers are a covered member benefit, understand the demand of their millennial population, and ask the right questions to their health plans. 

Self insured employers are realizing the benefit of their own care management by directly contracting with birth centers or a provider network of birth centers of excellence credentialed by MyBirthSpace.

Questions for Employers to Ask Health Plans may be found at AABC