Medicaid women and Birth Center Midwifery Care

Best Start Birth Center was a model birth center for CMS Strong Start Study

Best Start was a participant in CMS Strong Start grant through the American Association of Birth Centers which involved pregnant Medicaid women and birth center midwifery care. This grant program compiled data for pregnant Medicaid women receiving birth center midwifery care in birth centers across the United States: Outcomes of pregnant women with birth center care for Strong Start Grant between 2012 and 2014 are available: This study demonstrates that the birth center midwifery care achieves the triple aims of improved population health, patient experience, and value. Best Start achieved Best Practice for the Triple aim achievement in 2015 and 2016 /about/our-statistics/

Strong Start demonstrated that pregnant Medicaid beneficiaries achieved high quality outcomes at birth centers utilizing high touch, low technology midwifery model of care which produces high quality outcomes aligned with the national goals. Birth center care yields approximately 75% fewer cesareans. Using the financial model in Stapleton et al. (2013), savings would be almost $5 million in facility charges alone for the cesareans prevented. This does not include savings from decreased morbidity and avoidance of longer hospital stays.

There is also a cost savings associated with preterm birth. The national preterm birth rate varies nationwide but averaged 9.6% for 2014 births. For some populations and areas of the US, rates are much higher than this. The preterm birth rate for Medicaid beneficiaries in Strong Start birth centers was 4.75% for >4000 births, which is 50% of the national average. If 10,000 women who are Medicaid beneficiaries had prenatal care in the birth center rather than usual care, this could potentially save 485 preterm births or > $24 million. It is important that continued access to birth center midwifery care be promoted at the national and state levels. Birth centers have shown themselves to provide excellent care with high quality outcomes and at an increased benefit of providing a cost savings for payers.

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