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Freestanding Birth Centers2019-04-16T11:56:16-06:00

Freestanding Birth Center Consulting

Although the vast majority of births in the United States still occur in hospitals, a growing number occur outside hospitals.  For the medically appropriate patient and patients desiring limited reliance upon interventions, freestanding birth centers provide a cost-effective and safe alternative birthing venue.  In addition to recent developments in bundled payment models aimed at lower cost and higher quality, freestanding birth centers are uniquely positioned to advance this trend.

What is a Freestanding Birth Center?

Birth Centers provide a homelike birthing alternative for healthy women deemed to be at low risk for complications. Freestanding birth centers are typically located outside the hospital setting (although some states allow for similar birthing units within a distinct area of the hospital).  While several state and federal definitions exist, the Commission for the Accreditation of Birth Centers definition announces “a homelike facility existing within a healthcare system with a program of care designed in the wellness model of pregnancy and birth.  Birth centers are guided by the principles of prevention, sensitivity, safety, appropriate medical intervention, and cost effectiveness.”

In general, maternity care in freestanding birth centers is provided by midwives.  The model of care employed by midwives typically results in interventions at lower rates; it provides an individual, rather than standardized, plan of care.  Patients needing a higher level of care are transferred to the hospital.

A typical freestanding birth center provides the following services:

  • Prenatal care,
  • Labor and birth (no Cesarean section procedures), and
  • Postpartum and newborn care.

Trends in Bundled Payment

Currently, in most instances, payment to providers is made for each service furnished to a beneficiary.  This fee-for-service model, however, can incentivize providers to employ interventions that result in higher costs but not necessarily higher quality.

A bundled payment model provides a single payment for an entire care episode. A bundled payment model has enhanced potential for cost savings and increased quality.  Pregnancy fits well in the bundling model because it is episodic in nature – it has a definite beginning and end.  Some commercial payers have already developed bundled payment models for maternity care.  In addition, some state Medicaid programs have adopted similar bundled payment models.  Because freestanding birth centers provide maternity care services at a lower cost than their hospital counterparts, they are well positioned to advance the trend of bundled payment models.

Advis is attuned to industry developments. Advis is available to assist you in studying the feasibility of developing freestanding birth centers.