P1.235: Assessing the Impact of Value-Based Payment (VBP) on Maternal and Infant Health Outcomes in Nevada

Background: The Maternal and Infant Health Initiative (MIHI) Value-Based Payment (VBP) program,
introduced in 2018 in Nevada, aimed to improve maternal and infant health by linking financial
incentives to high-quality, cost-effective care. The program's goals included reducing adverse
neonatal outcomes and promoting comprehensive prenatal care. This study evaluates the impact
of the MIHI VBP program on maternal and infant health outcomes by analyzing trends in
preterm birth rates, low birth weight, NICU admissions, and hospital re-admissions.

Methods: A trend analysis was conducted using state-level health data from 2015 to 2021, focusing on
neonatal health indicators such as preterm births, low birth weight, NICU admissions, and
hospital re-admissions. The data was analyzed to track changes over time and assess the
program’s impact.

Results: The analysis found an increase in preterm birth rates from 12% in 2015 to 16% in 2021, and a
rise in low birth weight from 10% to 14%. NICU admissions also increased, from 7% to 11%.
These trends suggest limited success in preventing high-risk births. In contrast, hospital re-
admissions declined from 5% in 2015 to 2% in 2020, then slightly increased to 3% in 2021,
reflecting the program’s goal of reducing unnecessary hospitalizations, though not necessarily
improving neonatal health outcomes.

Conclusion: The trends highlight gaps in the VBP program’s ability to address key maternal and infant health
challenges. Future refinements should focus on preventive care, social determinants of health,
and early interventions for high-risk pregnancies.