Comparison of Estimated Incentives for Preventing Postpartum Depression in Value-Based Payment Models Using the Net Present Value of Care vs Total Cost of Care

Abstract

Key Points Question Do value-based payment (VBP) models that share 50% of the 5-year expected health care savings estimated by reduced postpartum depression incidence offer larger incentives for clinicians to prevent postpartum depression than traditional VBP models that share 100% of 1-year actual savings? Findings In this decision analytical model with a simulated cohort of 1000 pregnant individuals enrolled in Medicaid, sharing estimated savings offered more than double the financial incentives for clinicians to prevent postpartum depression than traditional VBP models, assuming continuous health insurance coverage (ie, no churn). This incentive decreased as rates of annual health insurance churn increased. Meaning These findings suggest that VBP models that share expected future savings may offer greater incentives for implementing interventions that prevent postpartum depression, but additional policy action is needed to address challenges posed by health insurance churn.

Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

“… 37 Another study estimated that group counselling (costing £114 per mother) cost around £73 □ less than individual counselling (£187 per mother) for mothers with PND. 36 This study found that screening for PND costs less than £2 per mother. 36 Studies that combined screening for PND with an intervention were also found to be cost-effective, resulting in 29 more healthy women at a cost of £938 □□ per woman.…”

“… 36 This study found that screening for PND costs less than £2 per mother. 36 Studies that combined screening for PND with an intervention were also found to be cost-effective, resulting in 29 more healthy women at a cost of £938 □□ per woman. 38 The ICERs of the intervention branch compared with usual care were $13 857 per QALY gained (below the commonly accepted willingness-to-pay threshold of $50 000 per QALY gained) and $10 182 per remission achieved.…”

“…A decision analytical model used a simulated cohort of 1000 Medicaid-enrolled pregnant individuals to evaluate the healthcare costs for individuals receiving PND preventive intervention or not, for 1–5 years post partum. 36 This study found that providing preventive interventions for PPD resulted in an estimated 5-year saving of £602 □□ .…”

Postpartum Depression: Overcoming Mental Health Challenges during Parenthood

“…Longitudinal studies also show an increased risk of depression and anxiety in teenage years [25]. The financial cost of untreated perinatal depression is over 14 billion USD yearly [26] due to associated missed work/lack of productivity and treatment for perinatal depression itself [27] as well as the resulting comorbidities such as cardiovascular disease and hypertension [28] [29].…”