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Maternal and Child Health Journal

, Volume 21, Issue 3, pp 432–438 | Cite as

Delivery and Payment Redesign to Reduce Disparities in High Risk Postpartum Care

  • Elizabeth A. HowellEmail author
  • Norma A. Padrón
  • Susan J. Beane
  • Joanne Stone
  • Virginia Walther
  • Amy Balbierz
  • Rashi Kumar
  • José A. Pagán
From the Field

Abstract

Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk. The program includes a social work/care management component and a payment system redesign with a cost-sharing arrangement between the health system and the Medicaid managed care plan to cover the cost of staff, clinician education, performance feedback, and clinic/clinician financial incentives. The goal is to enroll 510 high-risk postpartum mothers. Assessment The primary outcome of interest is a timely postpartum visit in accordance with NCQA healthcare effectiveness data and information set guidelines. Secondary outcomes include care process measures for women with specific high-risk conditions, emergency room visits, postpartum readmissions, depression screens, and health care costs. Conclusion Our evidence-based program focuses on an important area of maternal health, targets racial/ethnic disparities in postpartum care, utilizes an innovative payment reform strategy, and brings together insurers, researchers, clinicians, and policy experts to work together to foster health and wellness for postpartum women and reduce disparities.

Keywords

Maternal Health Payment Reform Disparities Medicaid 

Notes

Funding

The funding was provided by Robert Wood Johnson Foundation (Grant No. 72257).

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Elizabeth A. Howell
    • 1
    Email author
  • Norma A. Padrón
    • 2
    • 3
  • Susan J. Beane
    • 4
  • Joanne Stone
    • 5
  • Virginia Walther
    • 6
  • Amy Balbierz
    • 7
  • Rashi Kumar
    • 4
  • José A. Pagán
    • 8
    • 9
  1. 1.Department of Population Health Science & Policy, Department of Obstetrics, Gynecology, and Reproductive Science, Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.College of Population HealthThomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Center for Population HealthLankenau Institute for Medical ResearchPhiladelphiaUSA
  4. 4.HealthfirstNew YorkUSA
  5. 5.Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew YorkUSA
  6. 6.Department of Preventive Medicine, Department of Pediatrics, Department of Obstetrics, Gynecology, and Reproductive Science, Associate Director of the Department of Social Work ServicesIcahn School of Medicine at Mount SinaiNew YorkUSA
  7. 7.Department of Population Health Science & PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA
  8. 8.Center for Health InnovationThe New York Academy of MedicineNew YorkUSA
  9. 9.Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA

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