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Integrating Maternity Care Through Bundled Payments In The Netherlands: Early Results And Policy Lessons.
Zoë T M Scheefhals1, Jeroen N Struijs2, Albert Wong3
1Zoë T. M. Scheefhals, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; and Leiden University Medical Center-Campus the Hague, the Hague, the Netherlands.
Health Affairs (Project Hope)
|September 3, 2024
Summary
Bundled payments for maternity care in the Netherlands reduced costs by 5% without impacting health outcomes. This value-based care model influenced provider behavior, showing varied effects across networks.
Area of Science:
- Health Economics
- Healthcare Management
- Maternal Health Services
Background:
- Bundled payments are a global trend in value-based healthcare.
- Evidence for bundled payments in maternity care is limited.
- The Netherlands implemented bundled payments for maternity care (2016-18).
Purpose of the Study:
- To evaluate the impact of bundled payments on maternity care.
- To assess changes in clinical and economic outcomes.
- To identify policy lessons for alternative payment models.
Main Methods:
- Quasi-experimental difference-in-differences design.
- Analysis of data from 2016-18 in the Netherlands.
- Comparison of outcomes before and after bundled payment implementation.
Main Results:
- Increased outpatient, midwife-led births; decreased in-hospital, obstetrician-led births.
- Changes observed in labor induction and cesarean delivery rates.
- Total maternity care spending decreased by 5% (US$328 per pregnancy).
- No significant changes in maternal or neonatal health outcomes.
Conclusions:
- Bundled payments can influence provider behavior in maternity care.
- Effects of bundled payments can be heterogeneous across healthcare networks.
- Future alternative payment models require clear goals and success definitions.
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