Aiming to improve maternity care quality and value, nonprofit group Childhood Connection released a vision statement and an action plan in Washington this week.
The documents were developed through the group's "Transforming Maternity Care" collaborative, which received input from more than 100 healthcare providers, hospitals, health plans, payers, educators, quality experts, and others during the past several years.
While "a wealth" of high-quality evidence and experiences are "readily available to improve maternity care," they are "not impacting most women and newborns," said Maureen Corry, Childbirth Connection's executive director. The group's vision statement is serving "as a starting point" to provide steps for "broad based maternity care system improvement."
In its blueprint action plan, the group said it believes that current nationally endorsed maternity care performance measures are lacking. In particular, it says that "significant gaps remain for numerous crucial maternity topics" when it comes to the National Quality Forum's 24 endorsed measures that apply to maternity care.
At the same time, it said that the generic Consumer Assessment of Healthcare Providers and Systems' (CAHPS) facility, provider, and health plan surveys "do not adequately address important dimensions of maternity care quality."
Five groups within the initiative developed 11 "blueprints for action" to improve maternity care quality and value. Here is a synopsis of those points:
Performance measurement and leveraging of results. Fill gaps to attain a comprehensive set of high quality national consensus measures to assess processes, outcomes, and value of maternity care, and create and implement a national system for public reporting of maternity care data.
Payment reform to align incentives with quality. Advance efforts toward comprehensive payment reform through a restructured payment model that bundles payment for the full episode of maternity care for women and newborns.
Disparities in access and outcomes of maternity care. Expand access to services that have been shown to improve the quality and outcomes of maternity care for vulnerable populations, and compare effectiveness of interventions to reduce disparities in maternity services and outcomes.
Improved functioning of the liability system. Implement continuous quality improvement and clinical risk management programs to identify, prevent, and mitigate adverse events in maternity care.
Scope of covered services for maternity care. Identify an essential package of evidence based maternity care services for healthy childbearing women and newborns, and use determinations about comparative effectiveness of maternity services to make coverage decisions and improve quality of maternity care.
Coordination of maternity care across time, settings, and disciplines. Extend the healthcare home model to the full episode of maternity care, and develop local and regional collaborative quality improvement initiatives to improve clinical coordination at the community level.
Clinical controversies (home birth, vaginal birth after caesarean, vaginal breech and twin birth, elective induction, and maternal demand caesarean). Align practice patterns and views of both maternity caregivers and consumers with best current evidence about controversial clinical scenarios and evidence based maternity care.
Decision making and consumer choice. Design system incentives that reward provider and consumer behaviors that lead to healthy pregnancies and high-quality outcomes.
Scope, content, and availability of health professions education. Align funding for health professions education with national goals for high-quality, high-value maternity care, and workforce development.
Workforce composition and distribution. Define national goals for redesign of the U.S. maternity care workforce based on a primary care model with access to collaborative specialty care.
Development and use of health information technology. Increase interoperability across all phases and settings of maternity care by creating a core set of standardized data elements for electronic maternity care records.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.