As we wrap up this series on Clinical Episodic Payment, I hope that some of you are interested in diving a bit deeper with us here at Maternity Neighborhood. Our goals for the next phase of development are centered around building out the infrastructure on our platform in order to provide you with all of the necessary tools to engage in new maternity payment strategies.
We are happy to talk to you or your state organizations about how you can plan ahead for these payment structures, which have the potential to transform the way maternity care is delivered in this country.
What are the RISKS of Clinical Episode Payments for your practice?
As the HCP-LAN points out, risk is a very relative concept in new payment design. Most of you are not concerned about the biggest risk that you, as maternity care providers, can’t provide better care at a lower cost. What is concerning is the fact that the other two areas of CEP experimentation, Joint Replacement and Cardiac Care, have become mandatory bundles for reimbursement from Medicare. While there is no indication that state Medicaid agencies will abandon fee-for-service contracts for maternity care, there is every indication that this model will become the primary focus over the next few years. This means that your billing structure is likely to change whether you’re ready or not, and these changes will happen to you, rather than with you.
Another area that can significantly impact your practice is new pricing models. Price points for standard services are due for an overhaul, with both positive and negative repercussions. With recognition that nonclinical services — such as patient education, care navigation and referral, shared decision-making and home visitation — provide benefit across the spectrum of risk for pregnant women, there will be more interest in finding ways to cover these services as part of the episode fee. While your practice likely already incorporates many of these services into your model of care, there is little measurement occurring around exactly what and how you manage pregnancy education and decision-making. Getting paid for these services will depend largely on your ability to show their value to your overall service delivery model.
How can Maternity Neighborhood help your practice get ready?
The Maternity Neighborhood Care Guide is specifically designed to measure these workflows and can provide your practice with the necessary data and feedback to deliver these services in the most effective and efficient ways possible. The Care Guide is now FREE for our EHR users and is also available as a stand-alone tool for those who use different technology (including paper!) to manage clinical care. We’d love to give you a demo and help you get started with this highly effective and engaging platform. Our curated library of resources now includes content from some of the most respected sources of patient education materials. Childbirth Connection, Lamaze International, The Dartmouth Institute, American College of Nurse Midwives and Seleni are just a few of our content partners. You can also add your own practice content and begin the process of documenting shared decision-making through the automated delivery system and eConsent features.
Midwife, CEO and Founder of Maternity Neighborhood
American Association of Birth Centers – Birth Institute
September 22-26, 2016
Midwives Alliance of North America
October 13-18, 2016