UnitedHealthcare Helps Support Moms’ and Babies’ Health Before and After Delivery with Bundled Payment Program

On May 17, 2019

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.

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.

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.

“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 provides 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:

• connect with a registered nurse 24/7 for support and information;
• monitor and track weight, set reminders to take vitamins and track appointments;
• take a health assessment and discuss the results with a nurse;
• receive customized weekly updates based on the baby’s gestational age;
• search for information about pregnancy symptoms and concerns;
• use a “kick counter” to track the baby’s movements; and
• 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.”

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