Traditional health plan maternity benefits were built to meet the needs of an older generation, relying on claims to identify potential health risks and conducting care management through telephone outreach. The rise of bundled payments for pregnancy have made it impossible for payers to identify pregnant members before they give birth, and millennials typically don’t want to talk with their health insurer (or anyone else) on the phone. As a result, the potential for this type of maternity program to positively impact outcomes and reduce costs is limited.

There are now new tools and solutions that provide an opportunity for benefits professionals to replace or supplement their existing benefits. When evaluating if your current maternity care program is working, or if another maternity solution may be more impactful, there are three guiding questions that can help employers determine what solution will be the most effective.

1. Is your program relevant to your people?

Traditional maternity benefits target women who are already pregnant — specifically, those who have told their employer that they are pregnant (likely in their second or third trimester). These benefits also rely on outdated methods to engage employees, all of which delays time-sensitive outreach by weeks or months. With 64% of women deciding to leave their job before they have their baby, these traditional programs are missing an opportunity to reach a much larger employee population: those who are thinking about starting a family, dealing with infertility or navigating parenthood. Employees may not be receiving the care they need because their benefits are not timely or easy to engage with.

[Image: Bloomberg]
[Image: Bloomberg]

When evaluating a maternity benefits solution, identify when an employee will start engaging with the benefits and how they will engage. Not only are many pregnancy complications avoidable with early and timely engagement, women are more likely to return to their job after maternity leave if they feel supported with their benefits (such as fertility guidance and return-to-work programs) before they get pregnant. Look for a benefit solution that engages employees early and includes parenting resources so your benefits reach more than just those who are pregnant.

2. Is your program reaching people at the right time?

The path to parenthood is different for each individual. A benefit that treats all pregnant employees the same way is missing an opportunity to engage and influence health outcomes — one-size-fits-all solutions can feel impossible to navigate and can deter engagement. This approach does not allow for an employee to take control of their healthcare, and it can be difficult to identify early risk factors for pregnancy complications such as preeclampsia, preterm delivery, or an unnecessary C-sections.

Look for a maternity solution that provides personalized, guideline-driven care that incorporates an individual’s medical history and health conditions. The best solutions encourage daily engagement by creating experiences based on individual health profiles that identify and intervene when employees are at risk for complications. Research shows that personalized guidance is incredibly important for consumers, and your employees want a personalized healthcare experience as well.

3. Is your program changing behavior?

One of the biggest challenges for maternity benefit solutions — and health programs in general — is demonstrating the adoption of new behaviors. Change doesn’t come easy, and if your benefits do not specifically target behavior change, there will be minimal impact.

Identify what behaviors your solution is aiming to change, and measure the impact. Have preterm births gone down? Are you better able to identify those struggling with postpartum depression and provide support? Look for a solution that has a track record of educating and motivating employees to take action when it matters the most.

Solutions that are built around evidence-based theories of behavior change have been shown to be successful in interventions targeting pregnant women. Empowering employees to make the best health decisions and engage in behaviors that lead to optimal health outcomes will decrease your overall healthcare spend and result in healthier, happier employees.

As you evaluate current benefit programs and new solutions, start by looking for those that help the right people, at the right time, deliver personalized information, and change behavior. These pillars will guide you as you evaluate which program is best and most effective.

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