The intersection of maternity care, data transparency, health care costs and patient safety in a weekly curated list of articles of interest.
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Vaginal Delivery After C-Section Often Safe
Most women who had a previous C-section scheduled another C-section for their subsequent birth, but about 20 percent attempted to give birth vaginally, which researchers call a VBAC (vaginal birth after cesarean). Of these, about 70 percent had a successful vaginal delivery, whereas the other 30 percent wound up needing a C-section anyway, according to the report, from the Centers for Disease Control and Prevention.
Maternal Morbidity for Vaginal and Cesarean Deliveries, According to Previous Cesarean History: New Data From the Birth Certificate, 2013 (CDC)
New Blueprint Seeks to Improve Patient Safety During Childbirth
As part of an unprecedented cooperative effort between several such organizations – including the American College of Nurse Midwives, the American Congress of Obstetricians and Gynecologists, the Association of Women’s Health, Obstetric and Neonatal Nurses and the Society for Maternal-Fetal Medicine – Lyndon and colleagues from these groups did two initial studies to identify the patient safety issues confronting nurses, midwives, physicians and others involved in maternity care. These studies uncovered communication problems and disconnects between clinicians and administrators as key threats to patient safety.
From the archives: Is Home Birth Safer than Hospital Birth? What Does New Research Show? (2014)
The Smoking Gun: How U.S. Health Care Came to Cost Insanely More
That first big leap is between 1982 and 1983. What was different in 1983 that was not there in 1982? DRGs, diagnosis-related groups — the first attempt by the government to control health care costs by attaching a code to each item, each type of case, each test or procedure, and assigning a price it would pay in each of the hundreds of markets across the country. The rises continue across subsequent years as versions of this code-based reimbursement system expand it from Medicare and Medicaid to private payers, from inpatient to ambulatory care, from hospitals to physician groups and clinics, to devices and supplies, eventually becoming the default system for paying for nearly all of U.S. health care: code-driven fee-for-service reimbursements.
Interview: Washington HCA policy change on early elective inductions
The Washington Health Care Authority (HCA) has announced that Washington Apple Health will no longer reimburse physicians and hospitals for elective birth inductions before 39 weeks without documented medical necessity. The policy, effective Oct. 1, seeks to promote the health of mothers and children in Washington by decreasing the number of non-medically necessary c-sections.
Court case shows how health insurers rip off you and your employer
Commentary: Blue Cross Blue Shield of Michigan added hidden fees to hospital claims
The fees came to light when Hi-Lex Controls, an automotive technology company, took Blue Cross Blue Shield of Michigan (BCBSM) to court in 2013 after becoming suspicious that the company had been systematically cheating it over 19 years. After reviewing evidence in the case, a judge ordered that BCBSM stop charging the hidden fees and pay Hi-Lex $6.1 million.
After suing and getting documentation from BCBSM, attorneys for Hi-Lex were able to show the court that BCBSM marked up hospital claims by as much as 22 percent. BCBSM didn’t disclose the markups, however. As part of the scheme, regardless of the amount BCBSM was required to pay a hospital for a given service, it reported a higher amount to Hi-Lex and pocketed the difference.
Annual Healthcare Cost For Family Of Four Now At $24,671