CenteringPregnancy™ Group Prenatal Care Program Results in Healthier Babies, Lower Costs

Study is First to Examine Savings from Value-Based Care Reimbursement
of Prenatal Care Program to Medicaid Payers

INDIANAPOLIS–(BUSINESS WIRE)–Increased reimbursement to doctors who offer group prenatal care
improves birth outcomes and significantly reduces Medicaid plan costs,
according to a new
study
co-authored by Anthem, Inc.

Medicaid is the largest payer of maternity health benefits in the U.S.,
and inpatient costs associated with preterm births exceed $6 billion per
year – representing half of all costs associated with infant births. One
in 10 American babies is born prematurely, placing the newborn at
increased risk of death, medical complications and lifelong health
challenges.

The study, published in the January-February 2017 edition of Women’s
Health Issues Journal
, is the first to examine the newborn intensive
care unit (NICU) cost savings from the group prenatal care program,
CenteringPregnancy, to payers when a managed care organization provided
enhanced reimbursement to doctors to defray the costs and reward
providers for encouraging patient participation in the program.

“Anthem is dedicated to the health of American families, which is why
our Foundation is a longtime champion of CenteringPregnancy through
financial support of the March of Dimes and the Centering Healthcare
Institute,” said Karen Shea, Anthem’s vice president of maternal child
health and one of the co-authors of the paper. “This study demonstrates
that designing payment programs that sustain CenteringPregnancy at the
ob/gyn practice level are a potentially sound investment for payers to
reduce inpatient costs and help more babies get a healthy start in life.”

The CenteringPregnancy model requires significant upfront and continuing
investment from practices, including patient education materials, annual
certification fees and office support staff training. Although increased
costs to the practices may be small in comparison with the potential
savings for payers and the overall health care system, it often remains
a barrier to implementation and few payers have developed enhanced
reimbursement policies to cover the cost of CenteringPregnancy.

The study examined an enhanced reimbursement pilot project from the
South Carolina Department of Health and Human Services to BlueChoice
Health Plan South Carolina Medicaid, which in turn passed the additional
incentive payments along to participating prenatal care practices.

The study compared a group of 85 pregnant women enrolled in Medicaid who
attended at least four CenteringPregnancy sessions with a similar group
of expectant mothers who instead saw their doctor individually. The
pregnant women participating in the CenteringPregnancy program had a 3.5
percent NICU admission rate, while 12 percent of the matched control
group had babies needing NICU care. The lower rate of hospital
admissions resulted in an estimated net cost savings of $67,293 for the
Medicaid managed care organization covering the 85 women.

The typical care model for women in the U.S. with uncomplicated
pregnancies involves brief individual doctor appointments focused on
identifying medical risks, with limited opportunity for counseling and
support. In the Centering Pregnancy model, groups of eight to 12
pregnant women due within the same month attend sessions with an
individual medical assessment followed by a 90-minute group discussion
on topics including stress management, labor and nutrition. The open
discussion format promotes information sharing among women, social
support and the involvement of significant others.

“The value of the group model is that it engages patients in their own
health, enhances the care experience for both patient and provider, and
creates a community of support,” says Angie Truesdale, CEO of Centering
Healthcare Institute. “All of these components contribute to cost
savings and healthier moms and babies.”

In addition to Anthem, representatives from BlueChoice Health Plan South
Carolina Medicaid, Greenville Health System and the Department of
Obstetrics and Gynecology at Greenville Health System co-authored the
paper.

About Anthem Inc.

Anthem is working to transform health care with trusted and caring
solutions. Our health plan companies deliver quality products and
services that give their members access to the care they need. With over
73 million people served by its affiliated companies, including
approximately 40 million within in its family of health plans, Anthem is
one of the nation’s leading health benefits companies. For more
information about Anthem’s family of companies, please visit www.antheminc.com/companies.

About the Centering Healthcare Institute

Centering Healthcare Institute is improving health by transforming care
through Centering groups. It has developed and sustained the Centering
model in more than 450 practice sites and in some of the largest health
systems in the world. They have partnered with many dedicated
individuals and organizations to build a future where group healthcare
becomes the standard of care. For more information on Centering
Healthcare Institute and the Centering models of group care, visit www.centeringhealthcare.org.

Contacts

Anthem Inc.
Joyzelle Davis, 303-831-2005
Joyzelle.davis@anthem.com