Details of Connecticut’s Maternity Bundle
- What does the “maternity bundle” mean?
HUSKY will pay providers prospectively (e.g., up front) a set amount of money for the vast majority of care that an expecting individual will need – from 40 weeks before birth to 12 months postpartum. The specific amount of money paid will be based on a blend of the statewide average cost for maternity care and the specific provider’s historical cost. Additionally, there will be a retrospective (e.g., at the end of the bundle) shared shavings payment based on maternity related care provided during the perinatal period and certain predetermined outcomes.
- What care will be paid for through the bundled payment?
The bundle will cover most services across all phases of maternal health, including prenatal, labor and delivery, and postpartum. For example, the bundle will include licensed nurse midwife provider and hospital fees, x-rays, lab work and diagnostics, breastfeeding support, specialists, prescription drugs, and more.
- What care will be paid for outside the bundle?
Certain care will still be covered but paid for separate from the bundle. This care paid for separately will include newborn care, behavioral health, substance use services, long-acting reversible contraceptives (a form of birth control), some high-cost medications, and care that is not related to maternity.
- Which provider is responsible for the bundle?
A pregnant person’s health provider – for example, their obstetrician, licensed midwife, or family medicine provider – will be the provider that is responsible (or “accountable”) for the bundle.
- Which members are included?
All people who are giving birth on Medicaid in Connecticut will be eligible for the bundle, with certain rare exceptions (for example, if they go off Medicaid at some point during the pregnancy or postpartum period).
- What time period is covered by the bundle?
The maternity bundle covers the period from 40 weeks before birth to 12 months postpartum.