Maternity Episode Payment Model Online Resource Bank

Maternity care cost varies significantly by payer (commercial or Medicaid), by type of birth (vaginal or cesarean section), and by setting (hospital or birth center). Prenatal care, labor and birth, and postpartum care are often paid for and delivered as three distinct periods when, in reality, they are all three phases of one episode in a woman’s life. To incentivize coordination across the practitioners and settings where the full spectrum of maternity services are provided, episode payment can be used with the goals of improving patient care, increasing coordination across services and providers, and lowering health care costs.

To accelerate the movement toward maternity episode payment models, the LAN developed recommendations for maternity episode design in the Clinical Episode Payment White Paper. It also operated the Maternity Multi-Stakeholder Action Collaborative, or “MAC” from December 2016 through September 2017.  The MAC’s goal was to accelerate the adoption of maternity care alternative payment models that improve outcomes and care experience for mothers and babies, and reduce the cost of care.  The operating framework for this was the LAN’s Clinical Episode Payment White Paper maternity recommendations. Over the 10 months that the MAC was operating, there were nine virtual meetings held to provide learning and expertise on topics related to design and implementation of maternity episodes, including making the business case, selecting and using quality measures, determining services and population, developing the episode budget, working with Medicaid Managed Care organizations, and others.

The LAN developed an online resource bank – built on the Clinical Episode Payment work group design elements “wheel” – which provides a one-stop-shop for all the information and resources, including:

  • The LAN CEP white paper maternity recommendations
  • Slides, e-books, and summaries from all of the MAC virtual meetings.

We encourage you to use this information and to keep the LAN informed of your work in designing and implementing maternity APMs.