Hospital-Affiliated Outpatient Birth Centers: A Possible Model for Helping to Achieve the Triple Aim in Obstetrics

At nearly 4 million deliveries each year, birth is one of the most common reasons women are hospitalized in the United States.¹ Costs for US maternity care are among the most expensive in the world. A comparison by the International Federation of Health Plans, which represents 80 health insurance companies in 25 countries, found that payments for vaginal deliveries in the United States ($17 354) were substantially greater than those of the next highest ranked country (Switzerland, $8307).² In addition, despite a greater cost for delivery in comparison with most other OECD (Organisation for Economic Co-operation and Development) countries, the US cesarean delivery rate is higher,³ without better birth outcomes. Worldwide, the United States ranks 48th in maternal mortality⁴ and 57th in infant mortality.⁴