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Steep Drop Seen in Medically Unnecessary C-Sections

Cheryl Clark, for HealthLeaders Media, March 3, 2014

In early 2012, the U.S. Department of Health and Human Services launched "Strong Start," which received broad support from the American Hospital Association, the March of Dimes, and numerous medical specialty groups such as the American Academy of Pediatrics and the American College of Nurse Midwives.

Also in 2012, the federal Partnership for Patients' Hospital Engagement Networks (HENs) effort included reduction of early elective deliveries as one of 11 quality improvement goals for more than 3,000 hospitals.

Last month, the American Hospital Association's HEN reported results from its first two years saying that among its 1,500 participating hospitals, interventions prevented 13,340 babies from being electively delivered prior to 39 weeks, and 640 babies "did not have to go to the neonatal intensive care unit." That saved the healthcare system $3.13 million.

The Centers for Medicare and Medicaid Services recently began posting on Hospital Compare rates of medically unnecessary early elective deliveries either vaginally or by C-section under 39 weeks.

And in some states, such as California and South Carolina, payers are tying rates of hospital payment to reducing early elective delivery rates, Binder says.

Length of Stay in NICUs
An important provocation was the anecdotal observation within the healthcare industry that hospitals that had high rates of early elective deliveries without medical justification also had higher numbers and long lengths of stay for babies in their neonatal intensive care units, which often is a hospital profit center.

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