Investing in CenteringPregnancy™ Group Prenatal Care Reduces Newborn Hospitalization Costs

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• 作者：Amy Crockett ; MD ; MSPH^a ; ^{acrockett@ghs.org}Author Vitae ; Emily C. Heberlein ; PhD^aAuthor Vitae ; Leah Glasscock ; MS^bAuthor Vitae ; Sarah Covington-Kolb ; MSW ; MSPH^cAuthor Vitae ; Karen Shea ; MSN^bAuthor Vitae ; Imtiaz A. Khan ; DO^dAuthor Vitae
• 刊名：Women's Health Issues
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：27
• 期：1
• 页码：60-66
• 全文大小：353 K
• 卷排序：27

文摘

CenteringPregnancy™ group prenatal care is an innovative model with promising evidence of reducing preterm birth. The outpatient costs of offering CenteringPregnancy pose barriers to model adoption. Enhanced provider reimbursement for group prenatal care may improve birth outcomes and generate newborn hospitalization cost savings for insurers. To investigate potential cost savings for investment in CenteringPregnancy, we evaluated the impact on newborn hospital admission costs of a pilot incentive project, where BlueChoice Health Plan South Carolina Medicaid managed care organization paid an obstetric practice offering CenteringPregnancy $175 for each patient who participated in at least five group prenatal care sessions.MethodsUsing a one to many case-control matching without replacement, each CenteringPregnancy participant was matched retrospectively on propensity score, age, race, and clinical risk factors with five individual care participants. We estimated the odds of newborn hospital admission type (neonatal intensive care unit [NICU] or well-baby admission) for matched CenteringPregnancy and individual care cohorts with four or more visits using multivariate logistic regression. Cost savings were calculated using mean costs per admission type at the delivery hospital.ResultsOf the CenteringPregnancy newborns, 3.5% had a NICU admission compared with 12.0% of individual care newborns (p < .001). Investing in CenteringPregnancy for 85 patients ($14,875) led to an estimated net savings for the managed care organization of $67,293 in NICU costs.ConclusionsCenteringPregnancy may reduce costs through fewer NICU admissions. Enhanced reimbursement from payers to obstetric practices supporting CenteringPregnancy sustainability may improve birth outcomes and reduce associated NICU costs.