Guest Blog Post: How the Midwifery Model Benefits Families and Payers

By: Tricia Balazovic and Dr. Steven Calvin, The Minnesota Birth Center

Childbirth is the leading reason for hospitalization in the United States.

Assuming a $10,000 savings per birth converted from cesarean to vaginal, and a reduction in cesarean rates from 30% to 20%, an employer with 25,000 covered lives and 350 births per year would see total annual savings of $350,000. This does not take into consideration additional savings from reduced neonatal care, complications and readmissions, all of which are more common for cesarean births.

From the MN Health Action Group Maternity and Infertility Employer Purchaser’s Guide.

The cost of having a baby in a hospital varies by nearly $10,000 across the United States. The analysis of 2011 data from 463 hospitals nationwide found the average bill for a maternity stay ranged from $1,189 to $11,986. Costs at hospitals with higher rates of cesarean delivery or serious pregnancy complications were much higher than those with lower rates, according to Health Affairs.

Highly variable interventional procedures (e.g., cesarean sections and early elective inductions) have been increasing dramatically over time, which is why we are committed to offering healthy, sensible alternatives. While our focus has always been on supporting the needs of our patients, in working with The Action Group on its Maternity and Infertility Employer Purchaser’s Guide, we gained a new and important perspective on the far-reaching implications these often-unnecessary procedures have on employers and other payers, too.

In our Mission Statement, we say: “The Minnesota Birth Center supports health and wellness for women throughout their life cycle in a manner that is safe and seamless. Women are encouraged and empowered through our midwife-led care model at clinics, birth centers and hospitals — which includes a medical safety net when necessary. Our core emphasis is support for the normal physiologic birth of a healthy newborn. We are committed to providing excellent clinical outcomes to satisfied women and families at a reasonable cost.”

True to our mission and complementing our work with The Action Group, we now offer the BirthBundle ® (BB), which assures access to the holistic approach of the midwifery model, coupled with complete price transparency. This innovative, comprehensive maternity and newborn service product provides better clinical outcomes to mothers at a lower cost, using a proven coordinated clinical care model that is paid as a single price for the entire prenatal, delivery and immediate newborn episode.

The BB includes the options of doula services, prenatal and parenting education, group prenatal services, water tubs for labor and birth, and self-administered nitrous oxide for pain control — all in an empowering birth environment that treats pregnancy and birth as normal events while still having an immediately available medical safety net for the rare complications.

Over 600 mothers have received care through the MBC since 2012, with high satisfaction rates and favorable clinical outcomes. Cesarean section rates are below 10 percent, and newborn outcomes are identical to those of babies born in the hospital. A majority of mothers and babies go home within 4-6 hours after birth and then have a follow-up home visit in 24-36 hours, at a cost that is substantially less than that of comparable hospital services.

With BB, we have an opportunity to start at the very beginning. We believe health care reform should start where we all did — with pregnancy and birth. The pregnancy episode is the ideal time to test new care delivery and payment models. As system changes occur and cost pressures increase, we expect the BB to become a very successful clinical and payment model across Minnesota and beyond.

Action Group members may access the Maternity and Infertility Purchaser’s Guide by logging into the Member Center from the homepage.

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