One of the problems with the fee-for-service payment system is that it’s a flawed method of payment for sick patients but it may be ever more flawed as a method of payment for those who are healthy. This point is one Katy B. Kozhimannil, Ph.D., made recently in an article for the American Journal of Managed Care.
An associate professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health, Kozhimannil wrote that payment models should compensate teams of physicians, midwives, nurses and other providers for delivering evidence-based services during pregnancy, childbirth and the postpartum period. These payment systems also should be based on the health risks of the mother and baby, she added. Continue reading
Image by Ray Dumas via flickr.
There was some good data analysis that turned personal for me last week, and I feel compelled to give a shout-out to the reporters and publications (Consumer Reports, CNN, Time) that covered the stunning rise in cesarean rates in the U.S. and revealed the enormous differences in C-section rates between hospitals.
This is really helpful stuff if you’re trying to find the best place to deliver a baby, as I’ve been for the past few weeks. And trust me, it’s no easy task.
I’m pregnant with my first child. As a health reporter, all the worries of pregnancy have been compounded by what I’ve long known about the health care system I’m up against.
The U.S. is a scary place to be expecting a baby. We spend more than any other country in the world on health care and more on childbirth related care – $86 billion annually – than on any other area of hospitalization, according to a 2011 editorial in the journal Contraception. Yet our maternal-fetal outcomes are some of the worst among developed nations.
Births in the United States went down nearly 2 percent in 2008, according to new figures [PDF] from the CDC’s National Center for Health Statistics.
Among the report’s highlights:
- The birth rate for U.S. teenagers fell 2 percent, reversing a two-year increase.
- The birth rate for Hispanic teenagers declined to an historic low.
- The cesarean delivery rate rose for the 12th straight year, to 32.3 percent of all births.
- The percentage of births born preterm declined 3 percent.
Health Journalism 2010
Learn more about “Pregnancy and childbirth trends: Issues of safety and choice,” a panel featuring Mark R. Chassin, M.D., president of The Joint Commission; Julie Deardorff, health and fitness reporter at the Chicago Tribune; Alan M. Peaceman, M.D., professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and chief of the Division of Maternal-Fetal Medicine at Northwestern Memorial Hospital; and moderated by Deborah L. Shelton, a Chicago Tribune health reporter.