Washington University School of Medicine
Presentation Abstract
Using Bundled Payment Models To Achieve Equity in Pregnancy and Postpartum Outcomes
There is growing interest in using alternative payment models to improve quality and outcomes, and promote the reduction of inequities, in peripartum and postpartum care. State Medicaid programs and private payers are experimenting with the use of pregnancy “bundles,” which tie together prenatal and peripartum care under a single payment. In theory, bundles should reduce fragmentation and improve care coordination, which has the potential to improve care and outcomes among high-risk patients. On the other hand, bundles may create incentives to inappropriately reduce care, or to avoid providing care for patients perceived to be at risk of poor outcomes. Currently, not enough is known about whether these bundles are successful in improving quality, outcomes, and equity, nor regarding their potential unintended consequences. This presentation will outline what is known so far on alternative payment models for pregnancy care, and highlight important gaps for future research.
About Dr. Joynt Maddox
Dr. Karen E. Joynt Maddox is a practicing cardiologist at Barnes-Jewish Hospital and an Associate Professor with tenure at Washington University School of Medicine and Washington University’s Brown School of Social Work. She is Director of the Center for Health Services and Policy Research at Washington University School of Medicine and Co-Director of the Center for Health Economics and Policy at Washington University’s Institute for Public Health. Her research expertise is in evaluating the impact of federal and state health policies, such as Medicare’s value-based and alternative payment models and state Medicaid expansions on quality, outcomes, and costs, with a particular focus on their effect on racial, socioeconomic, and geographic inequities. Dr. Joynt Maddox has authored over 250 peer-reviewed publications, and has received federal and foundation grants focused on issues in health policy. She served from 2014–2016 as Senior Advisor in the Office of Health Policy in the U.S. Department of Health and Human Services. She serves as the Associate Editor for health policy at the Journal of the American Medical Association, and is a member of committees related to quality measurement and payment reform at the National Quality Forum, American College of Cardiology, and American Heart Association. Dr. Joynt Maddox received her A.B. in public policy from the Woodrow Wilson School at Princeton University, and her M.D. from Duke University School of Medicine. She trained in internal medicine at Duke University Medical Center, and then in cardiovascular medicine at Brigham and Women’s Hospital. She also completed a research fellowship in health policy at the Harvard School of Public Health, from which she received her M.P.H.
Dr. Joynt Maddox disclosed the following conflicts of interest: work on the Centene Health Policy Advisory Committee, research funding from the National Institutes of Health and Humana related to value-based payment models and risk adjustment.