Reducing Early Elective Births Could Save $1B Annually

Cheryl Clark, for HealthLeaders Media , January 26, 2012

Additionally, pregnant women want more control over their time of delivery, and are unaware that they're putting their baby at risk.

Short added that in the last few years, "there's been an explosion of data" about early respiratory problems, neurodevelopmental outcomes, and new insights on the tremendous rate of brain growth in a fetus in weeks 37-39.

Suzanne Delbanco, Executive Director of Catalyst for Payment Reform, is pushing for health plans and other payers to change the way they reimburse for obstetric care so hospitals and doctors don't have an economic incentive to not do the right thing.

"If we were to pay hospitals a single blended rate for delivery, that resulted in added payment for vaginal births and a reduction in payment for Cesarean delivery, we would likely see the rate of elective Cesarean labor and delivery decrease," she said.

Some hospitals are enforcing programs to deter their doctors from scheduling Cesarean sections and inductions for non-medical reasons, Binder said. She indicated that Hospital Corporation of America has adopted such a policy. And from Leapfrog's data, it appears that of 27 Kaiser hospitals in California all reported data and all but three showed rates lower than 5%.

"We're not in the business of putting out fancy reports to sit on shelves and look pretty," Binder summed up. "We are in the business of making change and improving the quality, safety and efficiency of healthcare in this country. So we need this to change."

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