The document discusses the CenteringPregnancy group prenatal care model. It provides an overview of key aspects of the model including components, outcomes, evidence of effectiveness, and state-level implementations. Studies show CenteringPregnancy can reduce preterm births and low birthweights while increasing patient satisfaction. The model has been implemented in over 450 sites across the US and benefits from enhanced reimbursement policies that incentivize its adoption.

1. The CenteringPregnancy® Model
Sharon Schindler Rising, CNM, MSN, FACNM
Innovations in Maternity Care:
Better Outcomes, Lower Costs
NCHC Briefing
May 10, 2017
“Improving health by transforming care through
Centering groups”

2. WHY GROUP CARE ?
“It’s what you imagine when having a
baby. It’s personal, loving, relaxing,
and an amazing community.”(Centering mom)
“It’s the one thing in my week that
brings me joy.” (Centering provider)

4. Who is Centering?
450+ sites
50,000+ moms

5. Components of Centering Healthcare

6. ASSESSMENT

8. Community Building
Evaluation

9. “It’s what you imagine when
having a baby. It’s personal,
loving, relaxing and an
amazing community.”

10. Centering Meets the
Goal
of the Triple Aim

11. District of Columbia - 5 CenteringPregnancy + 1 CenteringParenting
Florida - 10 CenteringPregnancy + 1 CenteringParenting
Louisiana - 6 Strong Start CenteringPregnancy sites; LDH enthusiasm for
expansion, Medicaid supportive
Michigan - 14 CenteringPregnancy + 2 CenteringParenting; MI Primary Care
Assoc. & March of Dimes led consortia, Spectrum Health supportive, exploring
enhanced reimbursement
Pennsylvania - 17 CenteringPregnancy + 3 CenteringParenting; March of
Dimes led consortium, Dept. of Health supportive
Ohio – 31 CenteringPregnancy + 8 CenteringParenting. Funding included in
current budget plan
South Carolina - 19 CenteringPregnancy + 1 CenteringParenting
Centering State Snapshot

12. Milestones in South Carolina

16. Picklesimer, 2016
Using Blue Choice / Anthem claims data - Investing in
CenteringPregnancy for 85 patients ($14,875) yielded
a net savings for the MCO of $67,293.
Gareau, 2016
CenteringPregnancy reduced risk of PTB
(36 %, p < 0.05). For every PTB prevented there was
an average savings of $22,667. Also reduced the
incidence of delivering an infant that was LBW (44 %,
p < 0.05, $29,627). Additionally, infants of
CenteringPregnancy participants had a reduced risk of
a NICU stay (28 %, p < 0.05, $27,249).
South Carolina Case Study

18. Evidence to Action
Effectiveness Translation Dissemination
Cluster RCT, 14 Community Health Centers
and Hospitals New York City
(NIH R01MH/HD61175)

19. POST-HOC ANALYSES
50 % of visits attended
Less likely to have:
Preterm birth
Low birth weight
baby
Rapid repeat
pregnancy
Babies spent fewer
days in the NICU
More condom
use/less unprotected
intercourse
Greater care
satisfaction
N=1148 All p < .001 Ickovics et al. AJPH. 2016;106:359-365.

20. What are the Centering Outcomes?
33%-47% decrease in preterm birth
Increased breastfeeding rates
Decreased sexually transmitted infections
Longer interconceptional period
Increased immunization rates
Better attendance
More appropriate weight gain/loss
Improved coping strategies
High satisfaction of patients with group care

21. • Incentivizes model adoption for new practices;
expands access for patients
• Mitigates risk for practices associated with
business model change
• Incentivizes scaling of Centering at existing
Centering practices
• Tracks Centering claims data
• Enhanced payments scale in proportion to # of
patients in Centering
VALUE OF ENHANCED PAYMENTS

22. CHI data based on practice sites reporting on 10,800 women through CenteringCounts as of 12.31.15 and US data source: March of Dimes PeriStats 2013, CDC and HP2020
Low Birth
Weight
HP2020 GOAL 7.8%
CHI 6%
US 8%
Breastfeeding
HP2020 GOAL 82%
CHI 86%
US 80%
Preterm Birth
MOD GOAL 5.5%
CHI RATE 6.8%
US RATE 11.4%
97% patient
satisfaction

23. Looking Ahead
• Enhanced reimbursement
– Continuing essential benefits
• Robust research and evaluation
• Regional centers of excellence
• Government, foundation, and community
partnerships
• Large system adoption
• Kaiser
• Army

24. Building healthy communities
one group at a time

25. References
Ickovics JR, Kershaw T, Westdahl C, Magriples U, Massey Z, Reynolds H, Rising, S. (2007)
Group Prenatal Care and Perinatal Outcomes: A randomized controlled trial. Obstetrics and
Gynecology,110(2), Part 1: 330-39.
Picklesimer A., Billings D., Hale J., Blackhurst, D., and Covington-Kolb, S. (2012) The effect
of CenteringPregnancy group prenatal care on preterm birth in a low income population.
American Journal of Obstetrics & Gynecology Vol 206: 415. e1-7.
Picklesimer A, Herberlein E, Covington-Kolb S. (2015) Group Prenatal Care: Has its time
come? Clinical Obstetrics and Gynecology, 58(2): 380-391.
Gareau, S., Lòpez-De Fede, A., Loudermilk, B. L., Cummings, T. H., Hardin, J. W.,
Picklesimer, A. H., ... & Covington-Kolb, S. (2016). Group Prenatal Care Results in Medicaid
Savings with Better Outcomes: A Propensity Score Analysis of CenteringPregnancy
Participation in South Carolina. Maternal and child health journal, 1-10.

26. References
Crockett A, Heberlein E, Glasscock L, Khan I. (2016) Investing in CenteringPregnancy
group prenatal care reduces newborn hospitalization costs. Women’s Health Issues, 27-
1:60-66.
Ickovics, J. R., Kershaw, T., Westdahl, C., Rising, S. S., Klima, C., Reynolds, H., &
Magriples, U. (2003). Group prenatal care and preterm birth weight: Results from a
matched cohort study at public clinics. Obstetrics & Gynecology, 102 (5, Pt. 1), 1051–
1057.
Rising SS, Quimby CH. (2017) The CenteringPregnancy® Model: the power of group
health care. NY: Springer Pub.