Transform Maternity Care



Although research and women’s health institutions agree that C-sections are clinically necessary for no more than 15% of births, 33% of all women, in California and nationally, deliver by C-section. The current C-section rate is up 60% from 18 years ago.

Together with Members, PBGH aims to help drive down the low-risk C-section rate, beginning in certain California markets and then targeting other problem areas in the U.S.

PBGH released a Call to Action that puts forth the following four strategies which, when activated by Members, will have considerable impact:

  1. Leverage data for quality improvement. Members have the market power to pressure those hospitals performing below standards. To provide Members with the data they need to act, a Report by PBGH compares low-risk C-section rates among delivery hospitals in California.
  2. Implement consumer education and decision support. Members can deploy consumer education and decision support tools to educate expectant mothers on pregnancy decisions that influence her C-section risk. PBGH has developed a Guide for Members that evaluates and identifies best-practice tools.
  3. Redesign payment methods. With a grant from the RWJF, PBGH has successfully piloted a blended-case rate that compensates physicians/hospitals the same for C-sections and vaginal births, removing perverse incentives. PBGH will work with Members and launch pilots with additional hospitals.
  4. Review benefits design. Members can utilize and promote value-based maternity services such as doulas and midwives to help reduce C-sections.  To aid Members with their benefit-designs, PBGH will be hosting educational events in 2015.

Together, these strategies will reduce the average C-section rate while ultimately making mothers and families healthier and moderating costs.

More info...TMC Program Summary (pdf 101 KB)

Brynn Rubinstein
Senior Manager
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