Sindhu Srinivas
Sindhu Srinivas, MD, MSCE

The push is on to create a new payment system for U.S. health care. For years, administrators and policymakers have tried to move from fee-for-service–paying for each aspect of care–toward alternative payment models (APMs), which set a budget for an episode of treatment or a group of patients while offering incentives to improve quality. 

The federal government expects to use APMs for all Medicare and most Medicaid payments by 2030. But uptake has been slow, especially in pregnancy care. While Medicaid covers more than 40% of pregnancy services, few state programs now require APMs for pregnancy care.

Jordan Stone
Jordan Stone, MD

In a new JAMA Viewpoint, LDI Senior Fellow Sindhu Srinivas and Associate Fellows Jordan Stone and Arina Chesnokova, assert that APMs represent a promising opportunity to improve maternal health outcomes and reduce racial disparities. The authors review the current state of pregnancy-focused APMs in such states as Arkansas and Tennessee, and offer recommendations to guide the development of these models.

Arina Chesnokova
Arina Chesnokova, MD, MPH

Following this publication, the Centers for Medicare & Medicaid Services announced the new Transforming Maternal Health Model that promises to improve outcomes, reduce costs, and enable state implementation of value based care. The details of the model and of the state application process are forthcoming in the Spring of 2024.

The article, “Alternative Payment Models in Pregnancy to Improve Outcomes and Advance Equity,” was published on November 20, 2023 in JAMA. Authors include Jordan S. Stone, Arina E. Chesnokova, and Sindhu K. Srinivas.


Kaday Kamara

Kaday Kamara

Policy Coordinator

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