Making Pathways in Innovating and Advancing Maternal Health

For expecting mothers, getting the right care and support is critically important during pregnancy, childbirth and the postnatal period. Doing so can help prevent and treat severe pregnancy-related complications. That's why it's important to provide a continuum of care for maternal health.

Using an Episode of Care (EOC) payment model, we can focus on helping the patient (expecting mother) from the beginning of their pregnancy to after delivery, – promoting quality and effective maternal care. The approach used in Horizon Blue Cross Blue Shield of New Jersey's (Horizon BCBSNJ's) pregnancy EOC program helps to:

Reduce C-section rates and early induction rates
Encourage greater collaboration among doctors during a woman's pregnancy
Offer more coordinated care delivery.

Providers can also leverage technology and data analytics to further innovate care delivery. Axia Women's Health (Axia) – which has about 400 providers across five states, including New Jersey – has been pioneering a fetal monitoring pilot program with Horizon BCBSNJ's pregnancy EOC program.

About the pilot

Axia recently implemented a fetal monitoring program that can be managed remotely from a patient's home. The program is being piloted with 100 low-risk, voluntary participants, and Axia is hoping to expand the program in the future to improve outcomes for more expecting mothers.

Fetal monitoring is a key way to ensure the mother and her fetus(es) are on track to avoid risks and complications. Axia uses an INVUTM, a Food and Drug Administration-approved device, that works from a remote platform offering fetal and maternal heart rate monitoring via a wireless sensor band that the mothers place on themselves. The mother can access personalized insights via a smartphone app, while her doctor receives detailed data on maternal and fetal heart rates over time.

“We are excited to be able to share this wearable technology with women so they can have their baby monitored from home, and hopefully move the needle on patient outcomes,” said Dr. Elizabeth Cherot, Axia's Chief Medical Officer. “Whether that be with hypertension, preterm labor or even trying to figure out when women are in physical labor.”

Fetal monitoring is typically performed by trained health care professionals and assesses a baby's heartbeat during labor and birth. The information obtained from fetal heart patterns during labor can help determine whether or not an intervention is needed during the birth process.

Working together

By working with Horizon BCBSNJ, Axia was able to help patients access the device at no cost as part of their health plan benefits. This pilot program further aims to measure adoption and patients' response. With a remote device such as INVU, patients have a more convenient and alternative way to keep appointments from the comfort of their home.

Horizon BCBSNJ and Axia have also been sharing information and data since the implementation of the pilot program to help improve outcomes.

“I value the information we can obtain and exchange because I can't get all of the payer data I need as an outpatient facility from other resources,” said Dr. Cherot. “I wanted to see how this pilot program could save costs. Now, when I look at outcomes, I understand how we save costs by looking at the payer data, which is so important.”

The American Public Health Association has noted that maternal health is an important public health issue because there is an opportunity to end preventable deaths among all women.¹ Improving the well-being of mothers, infants and children is also an important national public health goal. Because maternal well-being can determine the health of the next generation, and can help predict future public health challenges for families, communities and the health care system, pregnancy often provides an opportunity to identify existing and future health risks in women and children.²

As an EOC partner, Dr. Cherot said it's also important that providers and payers work together so that all incentives are aligned. Through the value-based program, Axia is working to improve women's health outcomes by focusing on issues such as reducing C-section rates, which can result in increased risk for mothers-to-be.

According to Dr. Cherot, “We really are trying to build on our innovation and value-based care. We want better outcomes and satisfaction for patients, along with less costs. And that's sort of the triple threat, the ultimate goal; and to be aligned with a payer on that goal is fantastic.”

Sources:
¹ https://www.apha.org/topics-and-issues/maternal-and-child-health
² https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health