The birth of a healthy child is a happy event – yet, in the United States, not all maternity experiences are equal. In fact, the health equity disparities are stark with far-reaching consequences, not just for families, but for the entire healthcare system.
As significant payers in the U.S., employers have a unique opportunity to drive better health outcomes for their employees by prioritizing high-quality care. In doing so, they can simultaneously reduce health care costs—benefiting both their workforce, their bottom line and improving health equity.
A growing crisis
The infant mortality rate is on the rise in the U.S. – increasing by 3% in 2022 —the largest rise in two decades, according to the CDC. The U.S. has consistently higher infant mortality rates compared to other industrialized nations, and racial and ethnic disparities exacerbate the problem. Maternal mortality in the U.S. also remains the highest among developed countries, with approximately 22 maternal deaths per 100,000 live births, with the rate for Black women the highest of any group.
These grim statistics reflect demographic and social inequity. Language barriers can pose significant challenges, with one U.K. study revealing that patients who can’t speak English are 25 times more likely to die in National Health Services (NHS) maternity care.
The cost of caring for a preterm infant is high and rises significantly when complications arise. By reducing these complications, providers may be able to allocate resources more wisely and gain a clearer understanding of the needs within neonatal health services. Avoiding time in the neonatal intensive care unit (NICU) can be a big money-saver. Recent research shows how providing developmental care in the NICU helps cut down hospital stays and related costs. On average, this approach saves about $91,000 per infant.
Health Equity – The business case for a healthier workforce
The healthier the workforce, the more cost-effective and efficient the healthcare system becomes. This means keeping employees, their families, and their communities healthy isn’t just good for people – it’s also good for business.
Having access to high-quality care and health insurance coverage is essential for our physical, mental, and financial well-being—and Americans get that. In fact, benefits are a big draw for recruitment and retention of employees, with health insurance cited as the number one benefit workers look for when applying for a job.
The challenge: employers are burdened not only with direct medical expenses but also with indirect costs, such as lost productivity. When public programs like Medicaid fail to fully reimburse hospitals, those unpaid costs often shift to employer-sponsored insurance plans. For self-insured employers, for instance, one of the most effective ways to support new mothers is to ensure they can leave the hospital at the clinically appropriate time, allowing them to return to a sense of normalcy and focus on their new baby.
The solution: shift the focus to reducing the total cost of care while improving health outcomes. Currently, the healthcare system is designed to react to emergencies rather than prevent them. By prioritizing prevention and early intervention, particularly for high-risk groups—costs can be significantly reduced, and better results can be achieved. To make this a reality, investment must be made in preventive care programs and fostering stronger collaboration among all stakeholders, including employers and healthcare providers.
Own and know your data
Providers must be educated on the unique needs of each patient and develop customized treatment plans that account for factors such as race, ethnicity, and social determinants of health (SDOH), ultimately enhancing overall health outcomes. Employers should aggregate data to identify high-risk patients and predict potential complications during pregnancy. This approach provides critical insights for designing targeted mitigation programs that improve maternal outcomes.
When evaluating provider networks, it is important to prioritize those that emphasize preventive care, chronic disease management, and patient-centered approaches to improve overall health outcomes. Employers can transition to value-based care models, which reward providers for achieving better patient results rather than volume of services. Partner with accountable care organizations (ACOs) to promote coordinated and integrated care, ensuring employees receive streamlined, high-quality support.
Develop personalized health plans tailored to the unique needs of each employee, enhancing care relevance and effectiveness. Foster a culture of health within the organization by actively engaging employees in their wellbeing. Provide incentives for participation in wellness programs, health assessments, and lifestyle improvement initiatives to encourage healthier habits and sustained engagement.
The medication factor
As pharmacy benefit managers (PBMs) design prescription drug insurance plans, it is crucial to consider the needs of all communities.
Health equity must remain a priority for PBMs to ensure that individuals from diverse backgrounds are represented in drug decision-making. Different races and ethnicities may respond differently to medications, making it essential to account for these variations. While this approach may require additional time and effort, employers should insist that carriers and PBMs act as full partners in executing their strategies.
Personalized care
Investing in early, personalized care for mothers and babies can deliver significant benefits, such as fewer days in the NICU or ICU, improved health outcomes and a smoother healthcare experience overall. From the very start of pregnancy, care should be customized to address the unique needs of women based on their race and ethnicity. Implementing protocols such as early screening tests, effective management of comorbid conditions, mental health and substance use resources, and connections to community health coordinators is essential for ensuring the safety and well-being of both mother and child.
For employers, prioritizing long-term value over immediate cost savings pays off. Robust healthcare solutions lead to reduced absenteeism, greater productivity, and improved employee satisfaction and retention—all of which contribute to meaningful cost savings over time.
Health equity isn’t just a moral imperative, it’s also an economic necessity. By embracing their position of power, employers have the unique ability to drive a healthier future.
About the author
Robert E. Andrews is the chief executive officer (CEO) of the Health Transformation Alliance (HTA), an original author of the Affordable Care Act, and a former member of Congress. As CEO of the HTA, Andrews oversees the strategic direction of approximately 70+ major corporations that have come together in an alliance to do one thing: fix our broken healthcare system. Formed by four founding members in September 2015, the HTA member companies collectively are responsible for more than 8 million employees, dependents, and retirees with an annual healthcare spend of $30+ billion.
Through Andrews’ leadership, the HTA has launched value-driven solutions specifically designed to improve patient care and economic value through world-class data and analytics, pathbreaking pharmaceutical solutions, high-quality medical networks, and robust consumer engagement initiatives. To date, the cooperative has saved its member companies well over $2 billion in healthcare costs. Andrews’ leadership has been equally important in the HTA developing programs addressing racial and ethnic disparities in healthcare, mental health issues, and safe return-to-work programs following the pandemic.
Andrews served as a member of the United States House of Representatives for nearly 24 years. Upon his departure from Congress, President Barack Obama praised Robert’s service as “an original author of the Affordable Care Act … and a vital partner in its passage and implementation.”
