Maternity Care CDA

Maternity care CDA overview

A care delivery area (CDA) is an innovative value-based payment (VBP) arrangement. See the VBP Roadmap for Coordinated Care Organizations.

Maternity care is a significant opportunity for improvements in quality and cost in Oregon’s Medicaid program. Nearly half of all births in the state are covered by the Oregon Health Plan (Medicaid).

The maternity care CDA fosters innovative pilot VBP arrangements for providers across the spectrum of prenatal and postpartum care for a mother and their baby. Maternity care CDA pilots should be developed to provide comprehensive, integrated maternity care from “womb to crib” including, but not limited to, such services as:

Screening for domestic violence, substance abuse, and depression/behavioral health concerns;
Patient education;
Breastfeeding support; and
Doula care to support the health and well-being of the baby and family.

Recorded webinars

OHA CCO VBP Workgroup: Maternity episodes

Recording (3/14/23)

VBP and Maternity Care: What Have We Learned So Far? (OHA and Health Management Associates) - This provider-focused webinar reviews emerging models of maternity care to address SDOH and racial disparities and the VBP reform efforts to support them. The webinar includes approaches that have been implemented in Oregon and nationally, and their outcomes, challenges and lessons learned.

Slides / Recording (6/16/21)

Resources

Aligning Value-Based Payment with the CenteringPregnancy Group Prenatal Model: Strategies to Sustain a Successful Model of Prenatal Care
Rodin, D. & Kirkegaard, M., Centering Healthcare Institute

Reviews new opportunities to promote improved outcomes and lower costs in maternity care though the use of VBP strategies.
Key points: Demonstrates how the CenteringPregnancy model can be an effective and financially sustainable model of maternity care that meets the goals of VBP contracts.

Maternity Care Value Based Payment Arrangement
New York Department of Health

An overview of NY State's Medicaid maternity VBP arrangement.
Key points: Maternity VBP example that includes components of care, the underlying episodes of care, and the categories of measures recommended for New York State.

Maternity Episode Payment Models
Health Care Payment Learning and Action Network

Examples of several states' approaches to maternity care VBP models.
Key points: Ohio and Tennessee VBP frameworks, including key considerations and challenges.

Overview of the Neonatal Episode of Care
State of Ohio

Ohio's approach to a neonatal VBP model, using an episode of care model of payment.
Key points: The triggers and duration of a neonatal episode of care and risk adjustment with examples of performance scorecards.

Payment and Benefit Design for High-Value Maternity Care
Catalyst for Payment Reform

Key points: Includes a brief and slide deck with multiple perspectives on approaches to maternity care VBP.

Project Nurture Integrates Care And Services To Improve Outcomes For Opioid-Dependent Mothers And Their Children
McConnell, J et al., Health Affairs Vol 39. No. 4

This study assesses the impact of Project Nuture on a range of patient and child welfare outcomes.
Key points: Project Nurture was associated with reductions in child maltreatment, placement in foster care, and increases in both prenatal visits and maternal lengths of stay in the hospital.

Strong Start for Mothers and Newborns Evaluation: Year 5 Project Synthesis
Center for Medicare and Medicaid Innovation

Summarizes the Strong Start Enhanced Prenatal Care Model Program, a CMS innovation project to test models of prenatal care. It includes final project synthesis and evaluation results.
Key points: Three models of care were tested during the five-year initiative with dramatic reduction of preterm, low birth weight, and caesarean births for women who participated in birth center care compared with women of similar risk levels in usual care.

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