Steve Calvin M.D. on pregnancy care, health care reform, and innovation

Has paying for your pregnancy left you with a bundle of bills? Next time try the BirthBundleTM.

Pregnancy is a big enough physical and emotional challenge for mothers (and to a much lesser extent fathers) without the additional complications of how to choose, arrange, and pay for care.   It is difficult to decide on the various options for care and some parents are not able to tie up all the loose financial ends until their little one starts to walk.   For many families a pregnancy leaves them with a bulging folder holding insurance and billing letters from a long list of professionals and facilities that had a hand in the 9 months of care.  This is the bundle of pain that a disjointed fee for service system delivers.   There is a better way.

The better way comes from designing a system of perinatal care starting with the way that care is paid for.  It requires a new system covering the entire maternity and newborn care episode with one comprehensive payment.   This basics of this concept are described in a September 2013 paper from the Integrated Health Care Association:

http://www.iha.org/pdfs_documents/bundled_payment/Maternity-Issue-Brief-September-2013.pdf

Here at the Minnesota Birth Center we are building a new model that we call the BirthBundleTM.   True change will only come by starting with the foundation of primary maternity care and then building upward and outward to provide the necessary safety net.  Our foundation will be independent midwife-led birth centers integrated with obstetrical facilities and providers.   The BirthBundleTM is designed and provided by the Natal Network Inc., an entity that we have formed to coordinate all the moving parts.  We will be testing this model as a pilot with insurers and provider partners here in Minnesota.  Stay tuned for updates.

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Evidence-based maternity care

If you want to understand labor and its variations I highly recommend reading the excellent comprehensive summary by Rebecca Dekker PhD RN APRN from the University of … [Continue reading]

When we admit the error of our obstetrical ….

Cesarean section rates have doubled over the last 25 years.    This has occurred without evidence of benefit to mothers or babies.  In fact, the increase in rates has been physically and financially detrimental.    There are some key causes of … [Continue reading]

A New Inspiring Primary Care Model

A week ago I heard a couple of speakers at an Ashoka Fellows symposium in St. Paul.  One was Dr. Rushika Fernandopulle, founder of Iora Health  (http://www.iorahealth.com/).   Rushika is a talented and articulate physician who is starting from … [Continue reading]