CHA News Article

Issue Brief Outlines Maternity Care Patient Engagement Strategies
Publication to support California Health Care Innovation Plan’s Maternity Care Initiative

The Integrated Healthcare Association (IHA) has released the attached brief outlining patient engagement strategies in maternity care and the strategies that enable pregnant women to make informed decisions to improve their care, their health and the heath of their babies. The brief, titled Maternity Care Patient Engagement Strategies, focuses on California’s Maternity Care Initiative – one of the four initiatives included in the state’s Health Care Innovation Plan (Innovation Plan) submitted to the Centers for Medicare & Medicaid Services (CMS) on July 18 for a three-year state innovation model (SIM) testing grant. IHA has provided technical assistance on the Maternity Care Initiative to the California Health and Human Services Agency. The publication was developed to support this work.

Background

California’s Innovation Plan is organized into two main strategic components: 1) initiatives, which include four targeted health system and payment reforms, and 2) building blocks, which directly support the four initiatives and are designed to enhance overall data, transparency and accountability efforts intended to accelerate transformation throughout the state. The core organizing principle underlying all of the initiatives is care coordination, including team-based care and linking with community-based programs. The initiatives are:

  • Maternity Care. Promote safe, evidence-based deliveries to improve birth outcomes, promote maternal and infant health and reduce unnecessary costs.
  • Health Homes for Complex Patients. Implement and spread care models, which include coordinated, team-based care, to improve the quality of care and outcomes for medically complex patients and reduce costs associated with unnecessary emergency department visits and hospitalizations.
  • Palliative Care. Promote the use of palliative care when appropriate and in line with patient preferences, by educating patients, training providers and removing any structural or informational barriers to receiving care.
  • Accountable Communities for Health (ACH). Support development of two or three ACH pilots, which will model how population health can be advanced through collaborative, multi-institutional efforts that promote a shared responsibility for the health of the community. Pilots will include a wellness trust, which is designed to serve as a vehicle to pool and leverage funding from a variety of sources for long-term sustainability.

The building blocks are intended to address the capacities and supports necessary for health care transformation and payment reforms to succeed. Designed to sustain the transformation process over the long term, the building blocks address data, transparency and accountability issues on a system-wide basis. The building blocks’ goal is to enable California to track costs and quality across diverse systems of care, promote transparency and competitions, and drive continuous improvement. The building blocks are:

  • Workforce. Leverage and advance existing efforts to deliver team-based, culturally engaged health care services, focusing on support for training and technical assistance of key health personnel, including enhancing the ability of community-based health and other lower-cost workers to play an enhanced role, where appropriate.
  • Health Information Technology and Exchange. Target assistance to high-need entities and geographies developing health homes for complex patients, and support research analysis, including business case analyses, related to the take-up and spread of health technologies and data collection.
  • Enabling Authorities. Identify and secure needed policy changes that either remove barriers or create incentives to achieve the goals of the Innovation Plan. Because the initiatives proposed in the Innovation Plan build on existing innovations and activities in California, most can be implemented without significant legislative and regulatory changes. Two requests for Medicare waivers are included.
  • Cost and Quality Reporting System. Build on current efforts to create a robust reporting system that promotes transparency and monitors trends in health care costs and performance.
  • Public Reporting. Enhance state efforts to make data on health care quality, costs and population health – especially focusing on the Let’s Get Healthy California goals and indicators – readily available and accessible to stakeholders and the general public.
  • Payment Reform Innovation Incubator. Support an expanded private-public forum to facilitate payors, providers and purchasers building consensus on developing and implementing new payment reform methods and for calculating costs and impacts of payment reforms.

California’s Innovation Plan is projected to yield savings of $1.4 to $1.8 billion over three years – a more than 20-fold projected return on the potential $60 million SIM investment. For more information, see the following resources:

For more information on California’s Maternity Care Initiative, see the following resources:

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