Payment Reform: What lies ahead? What are CPMs doing now?

October 27, 2016

“Too often the resources spent on maternity care services are not leading to the highest value birth care…The good news is that evidence-based care practices can deliver higher quality care at a lower cost. For the majority of low-risk births, lower resource-intensive births correlate with positive outcomes.” Accelerating and Aligning Clinical Episode Payment Models, A White Paper published by the Health Care Payment Learning and Payment Action Network

Find out what leading stakeholders in in our health care system, including health plans, employers, state and federal agencies are saying about the need to reform our payment system and what it could mean in maternity care. Learn more about emerging payment models and what impact they could have on access to and payment for CPM services. Get a bird’s eye view of the payment landscape for CPMs today, including where Medicaid programs, the largest single payor of maternity care, are covering CPM care. Discover how CPMs are taking action at the state level to improve reimbursement for birth centers and expand employment opportunities for CPMs. Learn how NACPM, in collaboration with ACNM and the American Association of Birth Centers, are advocating for implementation of federal law that affects coverage of CPM services and birth center reimbursement.

Mary Lawlor, LM, CPM, and Executive Director of NACPM provided a national perspective on some of the opportunities and challenges for midwives in the context of both current and projected payment models. She described states where Medicaid covers CPM services, where there are barriers to public and private insurer coverage, and she listed steps NACPM is taking to address these issues.  She also described meetings at the Center for Medicare and Medicaid where NACPM, in collaboration with the ACNM and the American Association of Birth Centers, are making the case for the added value that CPMs can bring to maternity care and exploring ways in which the agency can improve implementation of ACA provisions related to birth center reimbursement. Download Mary Lawlor’s presentation slides

Karen Milgate, MPP, Health Policy Consultant presented how key elements of the Affordable Care Act and Medicaid initiatives call for significant changes in the way that health care will be organized and purchased in the coming years.  Karen has worked closely with the Health Care Learning and Payment Action Network as they have developed recommendations for payment reforms, including new models for payment of maternity care.  She described these models and explained where there may be opportunities for innovation that include midwives and birth centers. Download Karen Milgate’s presentation slides

Valerie Sasson, CPM – President, Midwives Association of Washington State. Licensed Midwives and birth centers in Washington State have been Medicaid providers since the 1980s, but the Midwives Association of Washington State has recently taken up the cause of adequate reimbursement for birth centers.  Val described the problem and the midwives’ efforts to secure better reimbursement.

JayVon Muhammad, CPM,  CEO of the Marin City Health and Wellness Center in California. Licensed Midwives in California have only recently achieved changes to their state laws that make it feasible for them to participate in Medicaid, including a provision for enhanced reimbursement.  As Director of a health center, JayVon explained how this has made it possible for her to employ Licensed Midwives.

Jennie Joseph, LM, CPM – a British-trained midwife, a women’s health advocate, the founder and executive director of Commonsense Childbirth Inc. and the creator of The JJ Way®. Licensed Midwives in Florida have encountered significant challenges in receiving adequate Medicaid reimbursement.  Jenny described her experiences and how she’s fought back. Download Jennie Joseph’s presentation slides