Monday, June 15, 2009

June 10 Q&A Outcomes and Rec re Costs

PeaceHealth hosted a June 10 Q&A meeting for pregnant women and families affected by the temporary relocation of Birth Center services during construction of a new facility at Sacred Heart, RiverBend.

With the exception of the pregnant families facing unexpected costs, the Q&A meeting paved the way for stakeholders –expecting women and their families, Friends of the Birth Center and community supporters, and PeaceHealth– to move forward through the interim period. Following are key take-away points and a recommendation for shielding expectant families from unexpected cost increases resulting from interim plans for services. Attendees also received a very helpful FAQ from PeaceHealth.

Facility update
  • PeaceHealth secured additional days at the current location. Services continue through July 8. Many thanks to PeaceHealth, as additional days mean some families will still be able to birth out of the hospital.
  • In light of the current economy, PeaceHealth is pursuing a rebid on the new facility. Incurred savings provide resources for restoring facility features previously trimmed.
  • Building permits are in place and construction could begin early to take advantage of summer weather.

Interim services
Birth Center and Labor & Delivery staff provided informative and reassuring descriptions of birth services inside the hospital. Mothers, many in their third trimester and anticipating out-of-hospital birth, appreciated hearing Birth Center and L&D staff talk about their decades-long relationship serving Birth Center mothers at the hospital.
  • Many birth center and hospital protocols are identical - mother’s preferences for monitoring and discharge can, in theory, be met.
  • Birth Center and L&D staff described the interim period as an opportunity to expand the number of Sacred Heart nurses trained to support midwifery-assisted birth. (Friends of the Birth Center has suggested PeaceHealth explore expanding its Baby Friendly designation to include Sacred Heart Medical Center. Many other top-rated hospitals have earned this prestigious designation.)
  • Birth Center staff are using and adding to prenatal education opportunities to work with women who had anticipated out-of-hospital birthing
  • Women and families are welcome to tour RiverBend’s birth suites. Online sign up: www.peacehealth.org/birthtours
  • Women and families are also encouraged to email feedback and questions to birthcenterphor@peacehealth.org
Hearing how Birth Center and L&D staff are collaborating to anticipate, reassure and support women who wanted an out-of-hospital option was one of the most positive outcomes of the open-format Q&A discussion. This was especially helpful for women who expressed concerns about being rushed through labor or viewed with irritation by hospital staff for wanting a non-interventionist approach.

Costs

Concerns over unanticipated costs were foremost among those in attendance. The majority of questions dealt with how and why costs for birth services would increase during the interim period. Expecting families asked that the original cost estimates be honored. PeaceHealth’s suggestion that each patient negotiate a payment plan for increased charges with Patient Financial Services was met not well received. As one pregnant woman soon to give birth stated: “I’m not asking for any handouts, I’m simply asking that I be charged the price I was quoted when I chose this service.”
  • Out-of-pocket payers are likely to be billed as much as $4,000 more than anticipated for a normal birth (See FAQ, page 2)
  • Women were directed to call Patient Financial Services at (541) 686-7191. Charity care and payment plans were suggested solutions to anticipated bills.

Recommendation
Friends of the Birth Center sincerely hopes PeaceHealth will find a way to honor cost estimates provided to expecting families who, in good faith, selected the Birth Center with the stated preference of an out-of-hospital birth. Births that would have occurred at the Birth Center, which result in low-risk, non-intervention, and early-discharge eligible outcomes would be extremely helpful. This would be a significant reciprocal good-faith act for the relatively small and finite number of families impacted by the strategic decision to preference sale of the current facility over informing them of the potential loss of the out-of-hospital birth option. Families, especially uninsured, out-of-pocket payers, would be protected from exorbitant, unanticipated medical bills.

Moving forward
Friends of the Birth Center takes seriously PeaceHealth’s description of us as a community partner and we believe that our contrasting perspectives are a valuable part of an ongoing, constructive relationship, cemented by shared long-term goals.

We appreciate CEO Mel Pyne’s continued accessibility and leadership and are hopeful that cost issues, especially for out-of-pocket payers, will be resolved.

Sunday, June 14, 2009

Eugene Sustainability Commission supports PeaceHealth efforts to relocate Birth Center to RiverBend

The City of Eugene Sustainability Commission recently sent a letter to PeaceHealth expressing appreciation for its efforts to relocate the Nurse Midwifery Birth Center to RiverBend.

The Sustainability Commission is a policy advisory group to the Eugene City Council and City Manager on the development of programs or actions to enhance sustainable practices within the community and city organization.

The future of the Birth Center aligns well with its mission and work:
The Sustainability Commission works to create a healthy community now and in the future by proposing measurable solutions to pressing environmental, social and economic concerns to the City of Eugene, its partners and its people.

Birth Center ahead of national efforts to effectively deliver preventive health care

Recent editions of Time and The New Yorker magazines explore the roles of cost, incentives, outcomes and the importance of preventive care within the health care delivery system.

The New Yorker: The Cost Conundrum


For 28 years, the PeaceHealth Nurse Midwifery Birth Center has provided accessible, affordable and outstanding mother-baby care in line with current efforts to emphasize preventive health care. At the June 2nd news conference announcing construction of the new Birth Center at RiverBend, Friends of the Birth Center offered the following description:
Among the finest in the nation, the PeaceHealth Birth Center provides affordable, accessible services with phenomenal outcomes in line with national and international standards for excellence in mother-baby care and breastfeeding. Along with being a well-loved and valued part of our community, the Birth Center is ahead of national efforts to better deploy limited health care resources.

Unique for providing a continuum of services before, during and after birth, the Birth Center model of care provides need-blind service and an emphasis on client-provider partnerships, education and prevention. Its emphasis on normalcy and healthfulness yields fewer billable procedures than the medical care model. Families, employers and insurers including public programs funded by taxpayers, appreciate lower costs, especially today. Savings continue postpartum through the Birth Center’s 24-hour breastfeeding consultation service and a weekly well-baby drop-in clinic. This upfront investment means fewer visits to the doctor and missed days at work.

The foundation of Birth Center care is its out-of-hospital setting. This critical feature promotes and protects the non-medical space in which women who use it want to give birth and initiate breastfeeding. Because the Birth Center exists within the health care delivery system, many women believe they receive the best of both care models. Consumers describe it as an incomparably valuable and necessary option for establishing family.

Thursday, June 11, 2009