Screening should be a continuous process, beginning at onset of the pregnancy and continuing postpartum. Comprehensive screenings uncover clinical risk factors (e.g., high blood pressure and diabetes) and social risk factors (e.g., behavioral health disorders and food insecurity). Early identification of risk factors and subsequent targeted support lead to better pregnancy outcomes. These include less preterm deliveries, healthier baby weights, and a decreased likelihood of complications during and after birth.

For example, the Maternity Support Program offered by Optum uses risk assessments at different stages of pregnancy to identify and connect high-risk patients with case managers. It has resulted in greater patient satisfaction, a lower preterm delivery rate, and a 2:1 return on investment. Decreased preterm deliveries have also generated significant cost savings, as preterm births typically cost employers 12 times more than full-term births. (Note: Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.)

Traditionally, all aspects of pregnancy care are delivered in an inpatient setting (i.e., prenatal visits, delivery, postpartum visits, and neonatal visits). But new technological advancements have made site-of-care shifts an increasing opportunity in pregnancy. For example, providers may use telehealth for postpartum depression monitoring, home care for tracking vital signs, and outpatient care for low-intensity visits.

Taking advantage of different care settings makes care more accessible for patients and frees up provider capacity for higher-risk patients. High-quality, accessible maternal health care leads to downstream benefits for patients as well as providers. Such care improves birth outcomes, reduces health disparities, and enhances the patient experience. By reducing demand from low-risk patients, provider organizations generate substantial cost savings. And patients are likely to return to organizations where they have had a positive experience with childbirth.

Wildflower Health’s new partnership with Providence is one example of how organizations can use alternative settings for pregnancy care. Through this partnership, patients will be connected to digital health tools that will provide support between provider visits and engage in remote health monitoring. Dedicated health advocates will also help with patient support and communication with the clinical team. Once launched, the program will track success on metrics like appointment adherence and provider satisfaction, with the goal to improve patient autonomy and provider efficiency.

Cesarean section deliveries make up over 30% of births in the United States and cost almost 1.5 times as much as vaginal deliveries. While it’s true that C-section rates are well above expert guidance, most clinical leaders caution against many strategies focused on reducing C-section rates because they may increase mistrust among frontline physicians. Patients themselves may also favor C-sections because of cultural or social factors.

The problem is, it’s impossible to say what the “right” rate of cesarean sections is. No two pregnancies are exactly alike, so capping C-section rates is unrealistic. For example, cesarean sections are appropriate in emergency situations—having strict protocols in place could interfere with physician discretion.

Note that we’re not saying that c-sections are, on their own, good or bad. They can lead to worse outcomes than vaginal births, but they are sometimes necessary. Navigating this issue can be tricky, and the trust of your physicians and patients is crucial to value-based care. So, focusing on C-section rates is not the place to start.

Although genetic testing holds exciting promise, it’s an emerging field. Prenatal genetic testing aims to uncover potential genetic disorders or birth defects in unborn babies. But inaccurate results could lead to thousands of wasted dollars in costly interventions and avoidable procedures. And so far the results aren’t too promising: certain tests for rare genetic disorders result in false positives between 80% and 93% of the time. For low-risk patients, the downsides of genetic screening may outweigh the benefits.