From the Research
The most effective strategy to reduce Non-Traumatic Spontaneous Vaginal (NTSV) cesarean rates is to implement a financial incentive program that rewards hospitals and providers for maintaining low cesarean rates, as evidenced by the study published in the Journal of Health Economics in 2009 1. This approach has been shown to be effective in reducing cesarean rates without compromising patient outcomes. The study found that a $1000 increase in reimbursement for a cesarean section increases cesarean delivery rates by about one percentage point.
- Key components of the incentive program should include:
- Tiered rewards for hospitals and providers that maintain NTSV cesarean rates below a target threshold
- Individual provider bonuses and institutional rewards for meeting or exceeding targets
- Implementation of evidence-based practices such as standardized labor management protocols and mandatory second opinions for non-emergent cesareans
- The program should also prioritize quality improvement initiatives, including:
- Appropriate labor induction practices
- Patience with the latent phase of labor
- Consistent interpretation of fetal monitoring
- A study published in the Maternal and Child Health Journal in 2016 found that financial incentives can influence the choice of delivery method, with a higher payment for cesarean sections leading to an increase in cesarean rates 2.
- Another study published in the BMC Pregnancy and Childbirth journal in 2019 found that non-medical factors, including financial incentives, can drive the increase in cesarean rates 3.
- Overall, the evidence suggests that a well-designed financial incentive program can be an effective strategy for reducing NTSV cesarean rates and improving patient outcomes.