A successful model for KSA-based payor-provider collaborative in maternity care

Maternity care in the Kingdom of Saudi Arabia (KSA) faces rising Cesarean sections (C-section) rates, fragmented care pathways, and a lack of standardized outcome measurement. This study evaluates the feasibility and early outcomes of a large-scale payer-provider Value-Based Healthcare (VBHC) pilot integrating Patient-Reported and Clinician-Reported Outcome Measures (PROMs and CROMs) across four tertiary private hospitals with active maternity/obstetrics departments in KSA.

A multicenter outcomes rollout pilot was conducted across four tertiary hospitals with dedicated maternity/obstetrics departments in KSA between July 2024 and July 2025. The International Consortium for Health Outcomes Measurement (ICHOM) Pregnancy and Childbirth Standard Set PROMs and CROMs were digitally collected at five predefined control points using a centralized interoperable platform from pregnant women aged 18-45 years. Site Rollout Teams were trained in VBHC principles, patient journey mapping, and outcomes utilization. Response rates, longitudinal PROMs trends, minimum important difference (MID) analyses, and PROM-PROM, PROM-CROM, and CROM-CROM correlations were evaluated.

A total of 802 women were enrolled, with an overall PROMs response rate of 38.7%. While mean PROMs changes remained below MID thresholds at the population level, approximately one-third of women achieved clinically meaningful individual improvements across key domains, including mental health, continence, breastfeeding confidence, and bonding. Hospitals implementing PROMs-triggered referral pathways demonstrated substantial reductions in abnormal outcome rates. Meaningful correlations were observed across psychosocial, functional, and clinical outcomes, supporting internal data validity and clinical coherence. Two providers achieved ICHOM Level 1 accreditation by project completion.

This pilot demonstrates that standardized PROMs and CROMs integration into routine maternity care is feasible and operationally effective in Saudi Arabia. Payer-provider collaboration, digital infrastructure, and clinician engagement enable actionable, patient-centered insights and establish a scalable foundation for VBHC-aligned maternity care and payment reform.