Addressing barriers to payment reform and quality improvement in maternity care in California

This project's payment-reform effort will enlist a California public-private health plan partnership and a Medi-Cal managed care plan to address the causes of poor value in California maternity care. Maternity care has emerged as an area of high opportunity for payment reform and quality improvement, due to the high costs of care and high variation in practice patterns, especially as related to cesarean deliveries. Current payment models for maternity services provide little incentive for physicians or hospitals to consider the medical necessity and appropriateness of performing a cesarean delivery over a vaginal delivery. This project will identify three California hospitals to participate and will involve patients by engaging them in the quality improvement aspects of the effort. First-year major milestones will include development of the maternity-episode bundle, recruitment of hospitals and physicians to participate in the program, implementation of the bundle, provision of technical assistance to those hospitals and physicians who participate in the program, and design of quality improvement programs. In Year 2, the project leads will continue to provide technical assistance and quality improvement support. In Year 3, the program will continue, a more sophisticated bundle may be implemented, and an evaluation will be conducted.

Grant Details

Amount Awarded $498,087.00

Awarded on: 4/16/2012

Time frame: 5/15/2012 - 5/14/2015

Grant Number: 69910


Pacific Business Group on Health

575 Market Street, Suite 600
San Francisco, 94105-5811


Diane Stewart
Project Director