Comparison of Estimated Incentives for Preventing Postpartum Depression in Value-Based Payment Models Using the Net Present Value of Care vs Total Cost of Care

Key Points

Question: Do value-based payment (VBP) models that share 50% of the 5-year expected health care savings estimated by reduced postpartum depression incidence offer larger incentives for clinicians to prevent postpartum depression than traditional VBP models that share 100% of 1-year actual savings?

Findings: In this decision analytical model with a simulated cohort of 1000 pregnant individuals enrolled in Medicaid, sharing estimated savings offered more than double the financial incentives for clinicians to prevent postpartum depression than traditional VBP models, assuming continuous health insurance coverage (ie, no churn). This incentive decreased as rates of annual health insurance churn increased.

Meaning: These findings suggest that VBP models that share expected future savings may offer greater incentives for implementing interventions that prevent postpartum depression, but additional policy action is needed to address challenges posed by health insurance churn.

Authors: Nathaniel Counts, Margaret Kuklinski, Venus Wong

Publication Date: April 2022