Building Service 32BJ Health Fund

According to the Centers for Disease Control and Prevention, more than 50,000 American women each year are harmed giving birth.

A lack of adherence to safety measures, excessive use of C-sections, and inappropriate early elective deliveries lead to harmful complications for both mothers and babies. A recent study found that New York State had the highest rate of maternal morbidity in the nation. Although maternity care is a service that consumers can plan ahead and shop for, drastic variations exist in quality, cost, and outcomes across hospitals—making deciding where to seek services difficult for consumers. Maternity care is also a significant cost driver for many purchasers, including the 32BJ Health Fund, which spent more than $21 million in 2018 on births for its members in New York State. In 2019, NYHealth awarded the Fund a grant to create a high-value maternity network for its members, who are predominantly lower-wage union workers and people of color, that will improve health outcomes while reducing costs.

Under this grant, the Fund developed a high-value maternity network of hospitals and providers that adhered to best practices for maternity care. The network increased quality, safety, member service, and overall value for labor and delivery, as well as postpartum care. The Fund then contracted with hospitals in the network for bundled payments for maternity services, which have been shown to reduce costs while improving health care quality. Plan participants were part of focus groups to assess how members currently select providers and hospitals for maternity care; what information is valued in that decision-making process; and what information would make members more likely to use the high-value maternity network. Educational materials were developed to advertise the network to members, using findings from the focus groups. The Fund evaluated the network to see if members changed their delivery hospitals; had lower rates of maternal harm at high-value maternity network hospitals than at other hospitals; and had lower episode costs at high-value maternity network hospitals than at other hospitals. Finally, a toolkit was developed for other payers, including private employers, public employee purchasers, and union health funds, to help them replicate the high-value maternity network.