Policy Development

CenteringPregnancy – Medicaid Enhanced Payment for Group Prenatal Care

State/Jurisdiction: Maryland New Jersey Ohio South Carolina Texas
Setting: Clinical
Population: Medical & Public Health Professionals
Topic Area: Access to Quality Healthcare

According to the Centers for Disease (CDC), one in ten babies born in the U.S. are preterm, meaning they are delivered prior to 37 weeks of pregnancy. Babies born early are at greater risk of not only early death, but also health and developmental problems that may present lifelong challenges. The U.S. preterm birth rate has been rising annually since 2014. Further, the CDC documents that African American women are 50 percent more likely than white or Hispanic women to experience preterm birth. Centering Healthcare Institute (CHI) is a registered 501(c)3 charitable organization with national reach. CHI is transforming healthcare delivery and outcomes for all families, beginning with pregnancy, by expanding access to our evidence-based framework for group prenatal care. CenteringPregnancy® brings birthing people out of the exam room and into a group setting where they learn from their providers and each other. In each two-hour visit there is ample time for health assessment, interactive learning and community building. Visits meet nationally recognized clinical standards and are facilitated by a credentialed healthcare provider. According to the American College of Obstetricians & Gynecologists (ACOG), group prenatal care has “demonstrated reductions in preterm birth and neonatal intensive care unit (NICU) admissions; increased birth weight for term and preterm infants; increased rates of breastfeeding initiation and continuation; decreased emergency department visits in the third trimester; improved pregnancy-related weight management; an increase in patients presenting in active labor and at greater cervical dilatation; increased patient and obstetrician and other obstetric care provider satisfaction; and improved knowledge of childbirth, family planning, postpartum depression, and early child rearing” CenteringPregnancy was recognized in both the inaugural and recently released second year Prenatal-to-3 State Policy Roadmap as an effective state strategy to reduce longstanding disparities in outcomes among racial and ethnic groups and socioeconomic statuses. We recommend an enhanced payment for evidence-based group prenatal care as an effective policy to incentivize providers to utilize this model of care that reduces health disparities and increases birth outcomes while saving payers precious reinvestment dollars. Most healthcare payment and coverage policies are made at the state level, both by Medicaid and other governmental insurance regulators and individual health plans. CenteringPregnancy is the billable healthcare visit and prenatal care through the 6-week postpartum visit has near universal coverage, making this an easily replicable policy.

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Implementation Handout

Centering Healthcare Institute
Kara Nett Hinkley

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