Cesarean Section Deliveries - How to Obtain Quality Care and Lower Costs

WHAT GROUP PURCHASERS CAN DO:

• Examine the C-section rates for your employees, members, or participants.
• Provide information to employees, perhaps in health newsletters, about hospitals with low C-section rates, and with information about vaginal births after C-sections.

WHAT INSURERS/HEALTH PLANS CAN DO:

• Select physicians and hospitals with appropriate C-section rates as preferred providers.
• Educate subscribers about the issue of vaginal births after C-sections.
• Compare your subscriber population to those of other insurers and payers.

WHAT MEDICAL PROVIDERS CAN DO:

• Compare your rates, lengths of stay, and charges to other hospitals and identify opportunities for cost reductions and quality improvement.
• Educate patients about the positive aspects of a vaginal birth after a C-section (VBAC).

WHAT POLICY-MAKERS CAN DO:

• Compare public-program populations to other subscriber populations.
• Use small area analysis data to identify geographic areas where C-sections may be over-utilized.

WHAT CONSUMERS CAN DO:

• Establish good communications with your doctor.
• Do not request a C-section without a medical reason or as a matter of routine. Depend on your doctor's judgment if he or she says the procedure is medically necessary.
• Ask about the hospital's capabilities in performing immediate C-sections. This would include having an anesthesiologist or anesthetist present in the hospital at all times.
• If you are uncomfortable with the hospital your physician recommends, ask about an alternative facility. Physicians often practice at multiple hospitals.
• Research one of the publications available which provide detailed information about preparing for pregnancy and delivery as well as providing additional questions to ask your physician and hospital. Hospitals and physicians often have different policies and approaches regarding childbirth.