Racial and ethnic disparities are persistent and widespread across maternal healthcare, primarily driven by socioeconomic status, geographic location and implicit provider bias. Compared to similarly developed countries such as Canada, Germany and Australia, the United State has the highest maternal mortality rate (MMR), at approximately 17.4 deaths per 100,000 live births, with the MMR steadily increasing since 2000. According to the CDC, non-Hispanic Black women are two to three times more likely to die from preventable or treatable pregnancy-related complications compared to white women[1].
To help address these gaps in care and to help ensure the better health of mothers, The Blue Cross Blue Shield Association enhanced its quality evaluation for the Maternity Care program to address key factors driving the United States’ maternal health crisis, such as preventable or treatable pregnancy-related conditions, high utilization of Caesarean sections and racial and ethnic disparities in maternal healthcare.
Overall, cost of care episodes for vaginal and cesarean births at BDC+ facilities are 20% less than those at non-Blue Distinction Centers+ facilities. The rates of Episiotomies were 49% less those at Blue Distinction Centers (BDC and BDC+) than at those at non-Blue Distinction Centers (BDC and BDC+). In 2018, BDC/BDC+ facilities across the country cared for more than 40% of Blue Cross and Blue Shield commercially insured women giving birth.
In 2020, the Blue Distinction Centers for Maternity Care Program was expanded beyond traditional outcome measures to include assessments of internal quality improvement, data collection and dissemination and internal protocols that better address clinical quality and equity issues in maternity care. New in the evaluation cycle, facilities must collect race-ethnicity data, have a maternal quality improvement program, commence drills and simulations for adverse events and have dedicated protocols and procedures for the management of hypertension and hemorrhage. In addition, they must meet clinical outcome metrics at a higher standard than required previously. Specifically, the rate for low-risk first-time cesarean sections (NTSV c-section rate, PC-02) has been aligned with the revised Healthy People 2020 goals. Facilities eligible for the Blue Distinction Centers for Maternity care show statistically significant differences in key clinical outcomes compared to their peers.
Quality is key: only those healthcare facilities that first meet Blue Distinction’s nationally-established, objective quality measures are considered for designation as a Blue Distinction Center+.
[1]https://www.cdc.gov/mmwr/volumes/68/wr/mm6835a3.htm?s_cid=mm6835a3_w
