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In Pursuit of Value-Based Maternity Care

Sudhof, Leanna MD; Shah, Neel T. MD, MPP

doi: 10.1097/AOG.0000000000003113
Contents: Medical Economics: Clinical Expert Series
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Value-based care has become the new paradigm for clinical practice, with significant implications for maternity services, where there is a large opportunity to provide better care at lower cost. Childbirth is the most common reason for hospitalization in the United States and represents the single largest category of hospital-based expenditures. At the same time, the United States ranks low among developed countries on measures of maternal and neonatal health, suggesting that we are not using resources optimally. Improving the value of maternity services will require public policies that measure and pay for quality rather than quantity of care. Equally important, clinicians will need to employ new strategies to deliver value, including considering prices, individualizing the use of new technologies, prioritizing team-based approaches to care, bridging pregnancy and contraception counseling, and engaging expecting families in new ways.

With the goal of providing cost-effective, patient-centered, evidence-based care, value-based medicine is the new paradigm for clinical practice, with significant implications for maternity care.

Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, and Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Corresponding author: Neel T. Shah, MD, MPP, 401 Park Drive, Landmark Center, Floor 3 East, Boston, MA 02215; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.