While payment reform is an important improvement lever, current incremental approaches to value-based
payment in maternity care are ill-equipped to facilitate needed systemic changes to promote equity and value in
maternity care by themselves. Payment reform alone cannot address the impact of institutional racism and implicit bias on maternal health outcomes. It is crucial to prioritize action items that get at the root cause of the most glaring issue with maternal health in this country: racial disparities. Culture change is hard to achieve because it requires commitment by leadership, and leaders across the health care industry – including policymakers – must first recognize and acknowledge the extent to which systemic racism and economic inequalities have been and remain drivers of racial disparities in maternal health outcomes in the U.S.

The Task Force, with support from The Commonwealth Fund, convened a cross-sector group of maternity health experts to identify strategies to accelerate the dissemination of effective value-based payment strategies and delivery models for maternity care. The findings are synthesized in this report: Promoting Equity and Value in Maternity Care. The report outlines a theory of change to chart the path towards a higher-value, more equitable maternity care system. An accompanying blog, Attaining Equitable High-Value Maternity Care, shares the definition and characteristics of high-value maternity care, with equity as a strong foundation, that was developed by the maternity care expert panelists.

Authors: The Health Care Transformation Task Force (HCTTF)

Publication Date: June 24, 2020

Theory of Change

developed to guide the Maternal Health Hub strategic objectives

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