Value-Based Care Incentives for Improving Maternal and Infant Care Delivery
Managed care plans are actively partnering with obstetric care providers through value-based care (VBC) initiatives to improve birth outcomes among Medicaid members. By offering clinical support in addition to higher VBC incentives, Elevance Health-affiliated Medicaid plans successfully supported care providers to improve birth costs and outcomes.
The Obstetric Quality Incentive Program (OBQIP) is an upside only, VBC partnership between Elevance Health-affiliated Medicaid plans and obstetric care providers. In order to earn VBC incentives, OBQIP providers must first achieve certain quality metrics.
While VBC programs are designed to improve quality and reduce costs, there is a lack of data available regarding the relationship between incentive payments and achieving quality goals. To understand what level of incentive is needed to transform care delivery, this analysis compared OBQIP providers to non-OBQIP providers. When incentive levels were higher, birth costs among OBQIP providers were significantly lower than for non-OBQIP providers. These findings suggest that offering clinical support and higher incentives for quality can improve birth outcomes among Medicaid members.
Related Public Policy Research
Late Medicaid Enrollment During Pregnancy Increases Risk of Mortality
Early enrollment into Medicaid managed care during pregnancy is important for timely access to prenatal care. This paper provides evidence that enrolling into managed care late in pregnancy impedes opportunities to identify serious conditions and therefore could increase the risk of mortality after delivery.
Later Medicaid Health Plan Enrollment Suggests Higher Infant Birth Costs
Timely enrollment in Medicaid managed care is crucial for individuals who are pregnant, allowing them to access prenatal care earlier in their pregnancy. Timely enrollment can also lead to improved birth outcomes and lower infant birth costs.
Maternal health disparities are worsening in the U.S., and care provider-focused initiatives are one strategy to improve maternal health outcomes, especially within Medicaid where women are at greater risk for morbidity and mortality.
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