Washington State Stacks Financial Incentives in Favor of Vaginal Birth

The state of Washington is taking an innovative step toward tackling rising cesarean section rates by eliminating the profit motive. Beginning this month, the state’s Medicaid reimbursement for uncomplicated cesarean sections dropped from approximately $3,600 to about $1,000—the same reimbursement provided for complicated vaginal birth.

Because the cost of vaginal birth is lower than the cost of c-section, the new payment structure rewards health care providers for supporting vaginal birth rather than for performing c-sections. Nearly half of all births in Washington are reimbursed through Medicaid, so the change is expected to have far-reaching effects. In fact, the state has already received calls from hospitals requesting assistance to revise the protocols they use to decide when a cesarean section is necessary.

A recent Crosscut.com article by Carolyn McConnell explains why this is an excellent way to improve maternal and infant health. It’s also in line with #5 and #7 of ACNM’s Seven Key Principles for Health Reform.

What do you think? Would you like to see the rest of the country adopt Washington’s new strategy?