Maternity Care Bundled Payments In The Netherlands: Changes In Health Outcomes, Spending, And Care Delivery After 5...

Area of Science:

• Health Economics
• Maternal Health
• Healthcare Policy

Background:

• Bundled payments are a growing global trend in healthcare reimbursement.
• Limited long-term data exists on their impact, especially within maternity care.
• Understanding these effects is crucial for optimizing healthcare spending and outcomes.

Purpose of the Study:

• To evaluate the five-year impact of bundled payments in Dutch maternity care.
• To assess changes in maternity care utilization, health outcomes, and costs.
• To provide evidence on the effectiveness of bundled payment models in this setting.

Main Methods:

• A difference-in-differences analysis was employed.
• Nationwide data from 2008-2021 in the Netherlands was utilized.
• 22,307 pregnancies in bundled payment regions were compared to 69,496 in control regions.

Main Results:

• Bundled payments correlated with an 8.9% decrease in midwifery-to-obstetric transfers.
• A 1.1% reduction in home births and a $121 decrease in spending per pregnancy were observed.
• No significant improvements in maternal or neonatal health outcomes were detected.

Conclusions:

• Bundled payments in Dutch maternity care modestly reduced healthcare spending and altered care processes.
• The observed changes in care utilization were not sufficient to yield measurable improvements in maternal or neonatal health.
• Further research may be needed to refine bundled payment models for enhanced health benefits.