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    This is why we need to accelerate value-based care

     

    While maternity care has been forward-looking in adopting value-based payments, more must be done to transform other clinical conditions to value-based care. Obstetrics evolved with the introduction of screening mechanisms and technology to confirm patients were healthily progressing through their pregnancy. Smartphones and new technologies can transform care delivery in all clinical disciplines. We believe that new digital tools and platforms are the key to helping physicians manage real-time patient risk, evolve toward value-based care and accelerate the transformation of care delivery.

     

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    With mobile telemedicine platforms, obstetricians and pregnant women are improving their ability to meaningfully interact between visits. Real-time readings from connected scales, blood pressure monitors and glucometers connected to the patient’s smartphone, create comprehensive data sets. This data provides a better picture of a woman’s pregnancy and health status, allowing both the care provider and the patient to be more engaged. As care delivery organizations are offered the necessary tools to monitor patients more closely, they will be better equipped to assume more risk and accept fully capitated payments, which would cover all pregnancies from conception to postpartum.

    Innovative health systems around the country are adopting this mindset to improve the quality of care while reducing cost. Health systems in South Carolina, for example, have engaged payers to cover the cost of telemedicine visits during pregnancy, greatly increasing access to necessary care. Other health systems around the country are deploying remote monitoring solutions to better engage with their patients between visits.

     

    HOT TOPIC: Wealth shouldn't make health. Period.

     

    In North Carolina, Cone Health has partnered with innovative companies to reduce the cost of outpatient prenatal care by 40%, detect cases of increased patient risk earlier through remote patient monitoring and deliver more personalized and convenient care experiences through technology for pregnant patients.

    We believe that individuals, policymakers, care providers and insurance companies can learn from these experiences and the application of this groundbreaking set of tools. A combination of payment and technological reform is crucial to ushering in a new wave of partnership among these stakeholders. Maternity care 2.0 is just the beginning.

     

    Resources

    OECD (2015), Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives, OECD Publishing, Paris.

    Kozhimannil KB. A Bundle of Joy? Bundled Payments for Maternity Care. The American Journal of Managed Care. May, 28, 2016.

    Lally S. Transforming Maternity Care: A Bundled Payment Approach. Issue Brief No. 10. Integrated health care Association. Sept. 2013.

    Williams T, Yegian J. Bundled Payment: Learning From Our Failures. Health Affairs blog. August 5, 2014.

     

    About the Authors

    Juan Pablo Segura is co-founder and president of Babyscripts, a Washington, DC-based technology company that builds mobile and digital tools to empower women to have better pregnancies.

    Kelly Leggett, MD, is a practicing OB-GYN and the clinical transformation officer for Cone Health in Greensboro, North Carolina. 

     

    Juan Pablo Segura
    Co-founder and president of Babyscripts.
    Kelly Leggett, MD
    Dr. Leggett is a practicing OB-GYN and the clinical transformation officer for Cone Health.

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    • Anonymous
      Agree with Nesondo... Value based payments are absolutely wrong as a mode of reimbursement. Too many variables - many of which are beyond the control of physcians/caregivers. Also "value" metrics necessitate documentation which has been proven to diminish "value" by taking docs from the bedside to the computer, an inherently "invaluable" manner of practicing medicine. Perhaps a better way to improve actual health would be quit making Americans sick. Let food stamps purchase ONLY fruits and vegetables, weight check-ins for those on entitlements (a basal welfare check and subtract from it if weight goals not attained), smoking subtractions. Other common-sense ideas to actually improve HEALTH. We are hostage to a narrative that health care APPEARS poor in the US whereas in reality, we know HEALTH CARE here is actually the best in the world. Too many noncompliant, exercise-phobic patients skew our outcomes??? Value based payments will simply exacerbate the problem.
    • [email protected]
      OB lends itself to this kind of billing. A single problem with a standard progression that resolves in 9 months. Compare that to diabetes. A lifelong problem that improves and worsens based on a stuttering progression that is HIGHLY correlated to patient compliance. Most chronic diseases do not easily fall into a "value based" billing model. Could you explain how pelvic inflammatory disease, or endometriosis could easily be billed based on "value"?

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