Group Prenatal Care: A Financial Perspective
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Group Prenatal Care: A Financial Perspective Rebecca A. Rowley1 • Lindsay E. Phillips2 • Lisa O’Dell3 • Racha El Husseini5 Sarah Carpino4 • Scott Hartman2
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Ó Springer Science+Business Media New York 2015
Abstract Introduction Multiple studies have demonstrated improved perinatal outcomes for group prenatal care (GPC) when compared to traditional prenatal care. Benefits of GPC include lower rates of prematurity and low birth weight, fewer cesarean deliveries, improved breastfeeding outcomes and improved maternal satisfaction with care. However, the outpatient financial costs of running a GPC program are not well established. Methods This study involved the creation of a financial model that forecasted costs and revenues for prenatal care
& Rebecca A. Rowley [email protected] Lindsay E. Phillips [email protected] Lisa O’Dell [email protected] Sarah Carpino [email protected]
groups with various numbers of participants based on numerous variables, including patient population, payor mix, patient show rates, staffing mix, supply usage and overhead costs. The model was developed for use in an urban underserved practice. Results Adjusted revenue per pregnancy in this model was found to be $989.93 for traditional care and $1080.69 for GPC. Cost neutrality for GPC was achieved when each group enrolled an average of 10.652 women with an enriched staffing model or 4.801 women when groups were staffed by a single nurse and single clinician. Conclusions Mathematical cost-benefit modeling in an urban underserved practice demonstrated that GPC can be not only financially sustainable but possibly a net income generator for the outpatient clinic. Use of this model could offer maternity care practices an important tool for demonstrating the financial practicality of GPC. Keywords Group prenatal care Financial feasibility Financial models Cost drivers Improved birth weight Healthcare economics CenteringPregnancyÒ
Scott Hartman [email protected] 1
Department of Obstetrics and Gynecology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
2
Department of Family Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
3
Department of Social Work, Patient and Family Services, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
4
Department of Nursing, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
5
Rochester, NY, USA
Significance What is already known on this subject? GPC, of which CenteringPregnancyÒ is the best studied, has been shown to provide clinical benefits to patients. Little is known about the costs of delivering this form of prenatal care in an outpatient office. What this study adds? This study is the first the authors are aware of to study the financial implications of GPC for an outpatient clinic delivering prenatal care in a group setting. The project is a
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