BCBSA seeks to reduce racial maternal care disparities

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The Blue Cross Blue Shield Association is kick-starting an effort to reduce ethnic and racial disparities in maternity care in about 600 acute care and pediatric hospitals across the country.

Starting this year, designated Blue Distinction Centers for Maternity Care will add health equity to the conditions on which they will now focus, in line with BCBSA's Maternal Health Equity Actions. Designations were effective January 1.

"The commitment that Blue Cross and Blue Shield companies made to reduce racial and ethnic health disparities is rooted in action," said BCBSA president and CEO Kim Keck. "The enhanced requirements for our Blue Distinction Centers can help millions of mothers across the country gain improved access to higher-quality, equitable care."

The Blue Distinction Centers for Maternity Care program play a role in BCBSA's National Health Equity Strategy aimed at confronting the nation's maternal health crisis from racial and ethnic health disparities by helping close clinical care gaps and break through any cultural, operational and structural barriers that persist throughout the maternal care spectrum.

WHAT'S THE IMPACT?

Data from BCBSA shows that designated facilities met the health equity selection criteria, showing 17% fewer cesarean births, 60% fewer elective deliveries and 26% fewer episiotomies than the national average.

Because internal data shows severe maternal morbidity rates are on the rise, and Black women are three times more likely to die from a pregnancy-related cause than white women, the Blue Distinction Centers for Maternity Care program enhanced its quality and measurement standards to recognize higher-quality facilities that have taken action to improve maternal health outcomes while reducing disparities.

Facilities that meet the program's selection criteria are eligible for designation at one of two levels: Blue Distinction Centers (BDC) are classified as healthcare facilities that deliver quality care, safely and effectively; Blue Distinction Centers+ (BDC+) do all that, in addition to demonstrating more affordable care. BDC+ designated facilities also exhibit an average savings of 21% for maternity care, according to a recent program survey.

To be designated under this program, each applicant facility was evaluated on a combination of objective data on patient outcomes, as well as on a number of practices, including:

• using evidence-based best practices to respond effectively to obstetric emergencies.
• offering unconscious bias training.
• participating in the regional Perinatal Quality Collaborative.
• supporting doula participation in the maternity care team.
• collecting race, ethnicity and language data.
• running drills and simulations to prepare providers for a range of obstetric emergencies.
• demonstrating health outcomes that exceed the selection criteria from the program's previous evaluation cycle.

THE LARGER TREND

Understanding the disparities faced by various racial and ethnic groups is key to addressing preterm births and low birth rates, which should spur action from payers, providers and lawmakers, a 2023 Health Affairs study found.

Specifically, the authors said that state and local lawmakers wield considerable influence in reducing disparities in maternal health outcomes, since many originate from historically inequitable local policies.

One possible means of addressing the issue would be the development of surveys with disaggregated race and ethnicity data that's specific to a given community, though authors cautioned that it's a fine line between reducing health inequities and intensifying them through racial targeting.

Maternal care deserts are a known and increasing problem. Between 2020 and 2022 there's been a 5% increase in counties in the United States that have less maternity access, according to a March of Dimes report. There's a 2% increase in counties that are considered maternity care deserts.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.