Every day Maternity Care is in the news, as interest and focus on this topic continually grows. In our state, the Murphy administration and others are investing in improving maternal and child health. With so many different grants, quality collaboratives, and competing priorities we need an effective path forward to create sustainable change. That’s why I want to point you toward the recently released National Partnership of Women & Families Blueprint for Advancing High-Value Maternity Care Through Physiologic Childbearing. At the Quality Institute, we’re using this Blueprint to guide our work in maternal child health.

The Blueprint contains six strategies that we’ll be sharing more on in the future, but today I want to focus on Strategy 1: Improve Maternity Care Through Innovative Delivery and Payment Systems and Quality Improvement Initiatives. Behind the lengthy title are key strategies to connect quality improvements to the payment system.

Right now in New Jersey, there are statewide quality improvement initiatives at the health system level, as well as through the New Jersey Perinatal Quality Collaborative, a statewide partnership of committed stakeholders working together to improve the quality and safety of care provided to New Jersey’s mothers and babies, which is funded by the Centers for Disease Control and Prevention. The Quality Institute is also participating in their work. Additionally, with support from the Horizon Foundation for New Jersey, we have been partnering with the Greater Newark Healthcare Coalition to use best practices learned from high-performing hospitals around the state to improve maternity care in Newark.

This is all valuable work. But very little is happening in New Jersey to link quality improvement to the payment system.

About a year ago, I met with the benefits manager for a large New Jersey pharmaceutical company who was concerned that the Cesarean Section rate for her employees was around 40%. As a follow-up, she shared data on the number of employee births and the hospitals where the births took place. The total for the year was less than 20 births. While each birth is important, and while the costs to employers can be significant for each birth, 20 or even fewer births does not create the market power needed to create lasting change.

But if an even larger purchaser, the largest purchaser in the state, demanded change and built that change into its benefit designs and contracts then change and improvements to maternity care would happen across all hospital systems and communities. We’ve seen exactly that happen in California and other places.

We could see that change here as well.

I encourage you all to read the National Partnership Blueprint Strategy #1 and to also review the Quality Institute’s Medicaid 2.0 Blueprint for the Future, Recommendation #21 a., where we call for similar payment reforms, such as building a maternity episode of care and supporting programs such as Strong Start, maternity medical homes, community health workers, and other supports for improving maternity care.

Our traditional fee-for-service payment models foster care that generates payments regardless of quality outcomes or the value or need for services. Well-designed payment models will support higher quality and value care. The State, through Medicaid and the State Health Benefits Program, pays for over half of all births in New Jersey. Our state is a payer with some serious leverage. Let’s get going. I encourage you to join me in this call to action and to read these blueprints.