April 20, 2020

Telehealth Providing Critical Pregnancy Support During Pandemic

Telehealth has emerged as a vital tool for helping expecting mothers and clinicians manage pregnancy in the time of COVID-19.

That was the overarching take away from a recent webinar on maternity issues and the COVID-19 pandemic held by Pacific Business Group on Health and co-hosted by the Washington Health Care Authority and Washington Health Alliance. Participants included employers who help cover the costs of about 70% of all births in Washington state.

Telehealth’s ability to regularly connect pregnant women and their doctors has become essential in the face of the need to practice social distancing, which keeps expectant moms at home, employers said. An audio-visual link becomes particularly useful as mothers approach their due date or face the questions and concerns that inevitably follow birth.

According to employers, a growing number of health plans are making changes in telehealth coverage due to the pandemic, including waiving costs for patients who access care this way.

Ensuring that both payers and providers continue to support and expand telehealth services after the pandemic eases will be important, they added. On April 14, the Federal Communications Commission (FCC) announced a $200 million program to help non-profit providers establish telehealth services to better connect with patients.

Adjusting to the new normal

Beyond increased use of telehealth, employers said the epidemic has resulted in a small percentage of pregnant women (5-10%) requesting transfers to birthing centers to avoid the risks of COVID-19 infection by delivering at a hospital. While most women will still deliver in a hospital setting, the current crisis has underscored the need to leverage all available maternity assets in our communities.

Developing a better understanding of how health benefit designs can create incentives for giving birth in settings outside the hospital, when appropriate, will be important for the future, employers said. Some webinar participants suggested that designating specific medical centers or alternative care sites as maternity centers could reduce risk of infection.

Employers also indicated that innovative solutions are needed to provide socially isolated expectant moms and new parents with venues for learning and reestablishing a sense of community. Possible options could include weekly education and Q&A sessions via Facebook Live or regular forums for discussing pregnancy-related issues that could be established through an employer’s human resources department. Group prenatal classes not only engage patients in their care and improve quality, these types of resources provide expectant mothers with necessary support from both peers and providers during this vulnerable time.

Looking ahead: New Payment Models

Virtually all webinar participants agreed that the current fee-for-service payment structure constrains the way providers can deliver care, and that alternate ways of paying clinicians who provide maternity care are long overdue. New models are needed to support high-quality care that puts the patient’s needs first. Instead of having to ask themselves “can I bill for this,” providers could focus on simply delivering care in the most effective and patient-centered way possible.

Webinar participants echo what PBGH has been consistently hearing from patients and employers: the COVID-19 epidemic is creating an important catalyst for changes across health care and barriers to adopting telehealth more broadly may finally be coming down.

Author: Blair Dudley