Pregnant women in the United States experience delivery via cesarean and early elective deliveries at higher rates than medically recommended for positive outcomes. Additionally, such unnecessary interventions can increase the cost of care. Given that Medicaid pays for nearly half of all births, the use of unnecessary interventions has implications for both the health of Medicaid beneficiaries and costs to the program. State Medicaid programs are implementing payment initiatives to reduce unnecessary or potentially harmful procedures, including non-medically indicated cesarean sections and early elective deliveries, as well as to improve access to prenatal and postpartum care.
In this brief, we look at how state Medicaid programs are using payment incentives to improve maternal and birth outcomes. The brief first describes practices in maternity care that are known to influence maternal and birth outcomes. It then describes Medicaid payment models such as bundled payments, blended payments for delivery, pay for performance, and medical homes.