Purpose-Driven Collaboration 

MNPS was experiencing a dramatic rise in neonatal costs that threatened benefit sustainability; they needed a provider partner that could help improve health outcomes for expectant mothers and their babies through a bundled payment program.

Vanderbilt Health’s Employer Solutions team built and designed an enhanced medical care and service experience for expectant mothers—MyMaternityHealth— leveraging Cedar Gate’s advanced value-based care platform. Results and feedback from maternity patients indicated high satisfaction both clinically and financially:

  • Most of the care was provided at zero out-of-pocket cost to the patients
  • Net Promoter Score for the services was in the 90th percentile
  • MNPS documented savings of more than $400,000 in the first year as well as a drop in neonatal spend
  • C-section rates increased by 25 percent compared to market.

Vanderbilt Health has been building a bundled-care approach for several years, working to evolve from the traditional payment paradigm to value-based care. The collaboration with MNPS and Cedar Gate helped test and scale the program with substantive and meaningful results. The KLAS Points of Light recognition demonstrates how much the MyMaternityHealth bundle is improving the health of mothers and their newborns while also lowering the financial burden for everyone.

The Value-Based Care Evolution 

Our health care system sits at a crossroads; structural and financial challenges hover menacingly and jeopardize future stability. The outdated and ongoing fee-for-service model is weighing down a system already plagued with overwhelming macro-economic challenges combined with long-term industry trends that show little to no sign of improvement.

Today, however, viable alternatives are emerging. Plan sponsors and providers alike can benefit from comprehensive data sets, analytics, and reporting, along with population health management, that supports a multitude of health care initiatives. New and advanced integrated platforms enable access to critical, homogenized, and discoverable patient data. Providers benefit from predictive analytics that helps diagnose the root cause of variations in care delivery that unnecessarily drive up health care costs. Further, through integrated platforms, logistical workflows are streamlined for advanced, value-based payment models and help eliminate time-consuming, manual payment administration allocation and distribution processes.

With the cost of health care rising and national health spending predicted to grow to $6.2 trillion by 2028, the price of services will only accelerate. By focusing on partnerships with provider networks centered on preventive care, plan sponsors can decrease their health care expenditures and improve workforce productivity.

Health care is an ever-changing and, at times, volatile system. Enhanced adjustments, forward-thinking adaptations, and inventive improvements are required to meet the needs and demands of a growing market. The partnership between Vanderbilt Health, MNPS, and Cedar Gate accommodated situational realities, embraced a new payer model, and provided their employees—expectant mothers—valuable neonatal care while conserving school financial resources.

Value-based care is positioned to evolve and play a pivotal role in supporting ongoing and future health care operations. Its potential is boundless to help initiate a new system centered on improved efficiencies and empowering payer-providers to achieve optimum health care delivery.

The author, Jamie Dye, is President, Bundled Payment Division at Cedar Gate Technologies.