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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
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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
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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:
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connect with a registered nurse 24/7 for support and information;
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monitor and track weight, set reminders to take vitamins and track
appointments;
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take a health assessment and discuss the results with a nurse;
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receive customized weekly updates based on the baby’s gestational age;
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search for information about pregnancy symptoms and concerns;
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use a “kick counter” to track the baby’s movements; and
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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 UnitedHealthcare
UnitedHealthcare
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,
2018
2Optum Healthcare Economics Maternity Program
Analytics Study, 2018
3 Office of Disease Prevention and
Health Promotion
https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives
4
The Journal of Maternal-Fetal & Neonatal Medicine, 2016
https://www.tandfonline.com/doi/abs/10.3109/14767058.2015.1023187?src=recsys&journalCode=ijmf20
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