New health care model cut costs and reduced need for medical services for pregnant women and newborn

In a study to be presented Friday, Jan. 27, in the oral concurrent session, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, researchers will present their findings for a study titled, Pregnancy medical home: Outcomes and cost-savings.

The study set out to evaluate the impact of a pregnancy medical home model on the utilization of emergency services and hospital days in a low-income population. Texas Children's Health Plan and Baylor College of Medicine partnered to create a new health care model in Houston, Texas. The principles of patient-centered care found in a primary care medical home were expanded to include obstetrics and gynecology, creating a pregnancy medical home exclusively for women and children covered by Medicaid and the Children's Health Insurance Program (Chip).

The medical home integrates obstetrics/gynecology, maternal-fetal medicine, pediatrics, behavioral health, optometry, dentistry, radiology, laboratory and pharmacy—all in one location. The home provides team-based care with midwives and physicians in the clinic and a hospitalist model for inpatient care. Extended hours (66 hours per week for OB and 100 hours per week for pediatrics) and walk-in/same day appointments provide opportunities to avoid unnecessary emergency room visits.

The researchers compared this care model with traditional obstetric care and found that women receiving care at the medical home were significantly less likely to utilize the emergency room and also spent significantly fewer days in the hospital. In addition, their newborns spent significantly fewer days in the hospital and were less likely to utilize the emergency room.

"The decreased need to use these services resulted in an estimated annual savings of over $800,000 for pregnant women and over $1.6 million for newborns," explained Lisa Hollier, M.D., professor of obstetrics and gynecology for Baylor College of Medicine and one of the researchers of the study to be presented at the SMFM annual meeting. "We believe this model can readily serve as a national model for improved health care, substantial savings and improved outcomes," Hollier added.