The future health care landscape certainly portends pressures from patients, payers and society to focus on the value of our care delivery; a focus on quality alone may not be sufficient as cost forms half of the value equation. The impact of value-based care policies on obstetric anesthesia care is unknown, but it will be imperative for our subspecialty to be proactive in deliberations.

Value-based care is defined as care quality divided by cost. Fee-for-service health care reimbursement has been criticized because care value is degraded by incentives to deliver higher volume of care with less emphasis on improving outcomes or containing costs, particularly in procedural-based specialties such as our own. Alternative payment structures are being investigated with regard to their impact on care quality and cost. Among these are bundled care models.

Obstetric care is a natural target for bundled care payment. Reimbursement under this model would provide a...

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