Online Program

What will the rise of "value-based purchasing" of health services mean for reproductive health?

Wednesday, November 4, 2015 : 9:10 a.m. - 9:30 a.m.

Lois J. Uttley, MPP, Community Catalyst, MergerWatch Project/Raising Women's Voices, New York, NY
Kyle Marie Stock, J.D., Raising Women's Voices for the Health Care We Need, New York, NY
Christine Khaikin, J.D., MergerWatch Project of Community Catalyst, New York, NY
In theory, the “value-based purchasing” wave that is sweeping the country should enable women to get better quality reproductive health care at a lower cost to them and their health plans.  But to date, cost control has been the primary focus of these efforts and consumers (including women) have been largely left out of the decision-making. Worrisome for reproductive health is the fact that the CEO of a large Catholic health system is the chairman of a new health industry task force “dedicated to accelerating the transformation of the U.S. health system to value-based business and clinical models.”  The Task Force includes six of the nation’s largest health systems and four of the top health insurers, all committed to putting 75 percent of their business in value-based arrangements by 2020.  

This presentation will help reproductive health advocates learn about and begin to influence the design of value-based purchasing in their states. The authors will draw on their experiences tracking and influencing the introduction of value-based purchasing through a sweeping Medicaid redesign program in New York. The authors will discuss how women’s interactions with reproductive health providers could change with the introduction of financial incentives to control costs. They will outline concerns about potential introduction of religious restrictions on payment for reproductive health services in value-based systems led by Catholic hospitals. The authors will present model policies for ensuring transparency to the women whose providers are participating in these programs, and rewarding the provision of quality, comprehensive reproductive health access.

Learning Areas:

Ethics, professional and legal requirements
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe the movement toward "value-based purchasing" of health care in the United States and explain what is meant by this new term. Identify and explain the potential benefits for, or threats to, comprehensive reproductive health coverage and access from value-based purchasing. Describe the leadership role in value-based purchasing being played by a private health industry task force led by the CEO of a Catholic health system that does not provide most reproductive health services. Discuss the lack of involvement of reproductive health providers and recipients of those services, to date, in development of value-based purchasing models. Describe ways reproductive health advocates can begin to influence this new stage of payment and delivery reform so that it is transparent to affected women, includes sufficient numbers of reproductive health providers and covers comprehensive reproductive health services.

Keyword(s): Reproductive Health, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Director/Founder of the MergerWatch Project, which protects reproductive health access from religious restrictions. I advocate for reproductive health in health reform through my role as co-founder of Raising Women's Voices for the Health Care We Need. I serve on the steering committee of Health Care for All NY and on the advisory board to the NY State of Health ACA Marketplace. I previously was Vice President of Family Planning Advocates of NYS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.