AmeriHealth Caritas Louisiana Announces New Value-Based Model for Pregnancy Episodes

Bundles for Babies Program Aimed at Improving Outcomes for Pregnant Members

October 27, 2020 - Baton Rouge, La.

AmeriHealth Caritas Louisiana, a Healthy Louisiana Medicaid managed care health plan and part of the AmeriHealth Caritas Family of Companies, announced that it is expanding its PerformPlus® value-based care portfolio to include Bundles for Babies, a new episode-focused  program designed to improve health outcomes for pregnant members and their babies.

According to data from the Centers for Disease Control and Prevention, Louisiana’s preterm birth rate in 2018 was 10.2%, and part of a trend of rising prematurity rates across the country. Louisiana also ranks second-worst in the country in infant mortality[i]. While much work has been done by all the stakeholders involved to improve birth outcomes in the state, making a significant positive impact requires additional collaborative effort.

The Bundles for Babies episode-based model supports that effort by going beyond other value-based approaches to encourage and reward quality of care throughout a member’s entire pregnancy, including prenatal care, delivery, and postpartum care. This helps providers deliver more holistic care, which also helps to improve the patient experience.

Participating providers will be evaluated and compensated based on the episode performance and meeting or exceeding the following quality measures, all of which can influence the health of the mom-to-be and her baby:

  • Timeliness of prenatal care
  • Timeliness of postpartum care
  • Appropriate sexually transmitted infection screenings for pregnant women

AmeriHealth Caritas Louisiana will support participating providers with the data analytics required to help them be successful in an episode-based payment program. Providers will have access to data and analytics to assess quality, costs, and utilization performance. Participating providers will support program goals by delivering care that improves outcomes for AmeriHealth Caritas Louisiana members.  

“All of our value-based programs are designed to promote quality, efficient health care – but this new value-based payment model for maternity care is particularly exciting,” said AmeriHealth Caritas Louisiana Market Chief Medical Officer Dr. Rodney Wise. “The Bundles for Babies program will reward providers for focusing on the patient’s experience across the continuum of care.”

Women's Clinic of Acadiana is the first provider to sign on to the new program. The provider has a history of delivering high quality obstetrical care for pregnant members, having collectively delivered more than 20,000 babies. The new episode-based program with AmeriHealth Caritas Louisiana will build on that work.

“Entering episode focused value-based agreements requires a very strong relationship with a great deal of trust. Its success requires carefully aligning payer and provider goals – and a mutual commitment to ongoing collaboration.” said AmeriHealth Caritas Louisiana Market President Kyle Viator. “That describes our relationship with Women’s Clinic of Acadiana, and we are excited to join them in this next step in our relationship and in helping transform health care.”

“Addressing poor pregnancy and birth outcomes is a priority for Louisiana,” said Women’s Clinic of Acadiana Practice Manager Sara Foreman. “We focus on making sure our patients have accesses to the services and support they need to have healthy pregnancies. The Bundles for Babies program is an exciting opportunity to participate in a value-based agreement that aligns with our mission to deliver healthy babies and provide better outcomes for new moms.”

Providers interested in learning more about Bundles for Babies or other PerformPlus value-based program opportunities may contact AmeriHealth Caritas Louisiana’s Practice Transformation Director, Lee Reilly, at 1-504-218-9537.

[i] National Center for Health Statistics, https://www.cdc.gov/nchs/pressroom/states/louisiana/la.htm