Improving Health Equity through Increased Access to Prenatal Care Across New Jersey

The goal of ensuring women have access to quality prenatal and pregnancy care is to improve pregnancy health outcomes. Many factors, including race, ethnicity and socioeconomic status, can contribute to, or even delay, a woman's access to prenatal care. That's why Lifeline Medical Associates (Lifeline) and Horizon are working together to transform the way women get health care in New Jersey.

Addressing the Obstacles to Prenatal Care

“Providers and health plans need to make a long-term investment to address these issues, and that's what we are doing. Transforming health care is not going to be a one-year project, it is going to be a multi-year project, especially if we want to fix inequity and get costs and quality under control,” says Jack Feltz, MD, President of Lifeline and Chief Medical Executive Officer of Unified Women's Healthcare, the largest women's health organization nationwide with 2,000 physicians in 14 states with 170 providers throughout New Jersey.

Not surprisingly, when it comes to pregnancy, social determinants of care such as housing and nutrition can greatly affect the health of the mother and child, and vary from patient to patient. “We're looking at all factors and trying to individualize care for each woman,” Dr. Feltz says.

Supporting Pregnancy with Innovative Prenatal Care

Together, LifeLine and Horizon have taken a large step toward improving prenatal care through Horizon's value-based, pregnancy episode of care program (EOC). Value-based programs are transforming not only the way LifeLine educates, measures, incentivizes and rewards physicians in their practice, but how physicians are able to engage with patients in a way they've not done before. This is because Horizon shares data and information that helps improve and pinpoint ways LifeLine physicians can better work with women during their pregnancy and address any issues that may keep them from getting the care they need.

“Not surprisingly, when it comes to pregnancy, social determinants of care such as housing and nutrition can greatly affect the health of the mother and child, and vary from patient to patient. “We're looking at all factors and trying to individualize care for each woman,” Dr. Feltz says.

Supporting Pregnancy with Innovative Prenatal Care

Together, Lifeline and Horizon have taken a large step toward improving prenatal care through Horizon's value-based, pregnancy episode of care program (EOC). Value-based programs are transforming not only the way LifeLine educates, measures, incentivizes and rewards physicians in their practice, but how physicians are able to engage with patients in a way they've not done before. This is because Horizon shares data and information that helps improve and pinpoint ways Lifeline physicians can better work with women during their pregnancy and address any issues that may keep them from getting the care they need.

In addition to participating in the pregnancy EOC program, Lifeline developed the Innovative Prenatal Care initiative to guide women from prenatal care through the post-partum period and beyond. The practice looks at patient satisfaction, provider satisfaction and outcome-based factors such as the reduction of diabetes, avoidable complications, Emergency Room (ER) visits and others. Patients have access to remote care and monitoring through a phone app. By using virtual visits or services, patients have better access, reduced travel time and lower costs.

“In this prenatal care model, we engage with patients outside routine visits,” Dr. Feltz says. “It's important we consider every factor possible that might affect a woman's pregnancy, and how we can address it more comprehensively. We help ensure they can take care of themselves beyond the end of pregnancy.”

Lifeline, as well as other practices in New Jersey and nationally, embrace what is known as Centering Pregnancy. Patients attend group sessions with other women around the same gestational age in place of one-on-one visits.

During these sessions, they can see a variety of specialists who provide in-depth education. Patients also benefit from engaging with and learning from each other. Some statistics, Dr. Feltz says, show this group model helps improve outcomes and reduce cesarean rates.

Working toward a better future for mothers

For all patients, especially those who lack access to necessary care, it's critical that providers and health plans work together. By sharing information and working toward shared goals of improved patient health outcomes, they can address those issues that may keep women from experiencing a healthy pregnancy and reduce avoidable health emergencies.

“It's about a partnership with all stakeholders. Each of us have areas of expertise, and none of us have them all. Working in silos and independently, which has been the case for too many years, short-changes the patient,” says Dr. Feltz. “With the patient in the center, we can get the best results for everybody.”