title: Group Prenatal Care: A Financial Perspective.
abstract: BACKGROUND
  Multiple studies have demonstrated improved perinatal outcomes for group prenatal care (GPC) when compared to traditional prenatal care. Benefits of GPC include lower rates of prematurity and low birth weight, fewer cesarean deliveries, improved breastfeeding outcomes and improved maternal satisfaction with care. However, the outpatient financial costs of running a GPC program are not well established.
  
  
  METHODS
  This study involved the creation of a financial model that forecasted costs and revenues for prenatal care groups with various numbers of participants based on numerous variables, including patient population, payor mix, patient show rates, staffing mix, supply usage and overhead costs. The model was developed for use in an urban underserved practice.
  
  
  RESULTS
  Adjusted revenue per pregnancy in this model was found to be $989.93 for traditional care and $1080.69 for GPC. Cost neutrality for GPC was achieved when each group enrolled an average of 10.652 women with an enriched staffing model or 4.801 women when groups were staffed by a single nurse and single clinician.
  
  
  CONCLUSIONS
  Mathematical cost-benefit modeling in an urban underserved practice demonstrated that GPC can be not only financially sustainable but possibly a net income generator for the outpatient clinic. Use of this model could offer maternity care practices an important tool for demonstrating the financial practicality of GPC.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA. rebecca_rowley@urmc.rochester.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Rowley
authors.affiliation: Department of Family Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
authors.forename: Lindsay E
authors.initials: LE
authors.lastname: Phillips
authors.affiliation: Department of Social Work, Patient and Family Services, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: O'Dell
authors.affiliation: , Rochester, NY, USA.
authors.forename: Racha El
authors.initials: RE
authors.lastname: Husseini
authors.affiliation: Department of Nursing, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Carpino
authors.affiliation: Department of Family Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Hartman
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000191:economics; D003132:Commerce / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006123:Group Practice / Q000191:economics* / Q000592:standards*; D006801:Humans; D007182:Income; D007231:Infant, Newborn; D009774:Obstetrics / Q000191:economics; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*
keywords: CenteringPregnancy®; Cost drivers; Financial feasibility; Financial models; Group prenatal care; Healthcare economics; Improved birth weight