Empowering Health Care Consumers

Grantee Name

Northeast Business Group on Health

Funding Area

Empowering Health Care Consumers

Publication Date

March 2019

Grant Amount

$225,000

Grant Date:

2016-2019

A woman’s risk for an unnecessary C-section depends in large part on where she decides to deliver her baby.

In New York State, big variations among hospital C-section rates exist, which can impact the safety and wellbeing of mothers and babies. If provided with better education and information, many women could make more informed choices about where to seek prenatal and delivery care. Hospital-level data on key maternity metrics that affect a mother’s birthing experience, such as unnecessary C-sections, are often difficult to find.

Making hospital maternity metrics transparent and easily accessible is one way to ensure that expectant parents have a safe and healthy birth. NYSHealth awarded a grant to the Northeast Business Group on Health (NEBGH) to use maternity quality data to create a ratings system and online scorecard for hospitals with maternal services in New York City and on Long Island, where approximately 50% of all New York State births occur. NEBGH was one of a cohort of grantees selected to fund ambitious, large-scale projects and studies that help to arm consumers with tools and resources to inform their decision-making.

Outcomes and Lessons Learned

Outcomes and Lessons Learned

  • Conducted consumer focus groups to gather ideas and content for a website and participate in user-testing.
  • Created ExpectNY, a user-friendly website and tool with searchable data from 53 hospitals in New York City and on Long Island that expectant parents can use to explore their health care options and better prepare for a positive birth experience.
  • Built a database of critical maternity metrics for the website, which included rates for NTSV C-sections (C-sections that occur among first-time mothers who are at low risk of experiencing labor complications), VBACs (vaginal birth after C-sections), inductions, episiotomies, breast-feeding, and other indicators that expectant mothers may want to know when deciding where to give birth.
  • Conducted an extensive marketing campaign to promote and share the website via TV commercials, social media campaigns, media outreach, employer dissemination, and community outreach.

The project was successful in developing a website and tool that is clear and easy to navigate, and provides useful information on maternity metrics. Initially, NEBGH planned to develop a website for users to search and compare hospitals on different maternity metrics. Realizing that the site needed to be more than a scorecard and that expectant parents also needed to have a solid understanding of the various maternity metrics, NEBGH decided to include detailed explanations of each metric so that expectant parents can better grasp what the metric means, how the information can be used, and why it is important.

Publicly reported data were collected from Leapfrog Hospital Safety Grade, Health Data NY, Baby-Friendly USA, and various other sources. However, NEBGH faced challenges collecting nonpublicly available maternity metrics data directly from hospitals. To address this issue, NEBGH outsourced that task to a survey research firm that had strong contacts with New York City-based hospitals to field the hospital data collection survey. Another challenge was getting the NTSV C-section rates from hospitals, which aren’t mandated by federal or State law to report these rates; consequently, only 32 of the participating 53 hospitals voluntarily provided these data to Leapfrog. For the remaining 21 hospitals, the website lists “data not available” in this category. Efforts by policymakers would be needed to mandate the reporting of this metric. NEBGH will continue to update the hospital metrics as new data become available through Health Data NY and/or Leapfrog.

Leading up to and following the website’s launch in June 2018, NEBGH conducted an extensive campaign with partners to promote and share ExpectNY, including with Choice in Childbirth, New York City Department of Health and Mental Hygiene, and Healthy Start programs. Media and communications outreach was also robust, including commercials for ExpectNY on NBC and CBS, Facebook and Google ads, and press coverage such as in Newsday. NEBGH also presented on the website at conferences and stakeholder meetings, including at the National Alliance of Healthcare Purchaser Coalitions and Family Friendly Benefits.

Despite these robust promotional efforts, it has been challenging to achieve user engagement with the website. The goal was to reach 10,000 expectant moms by close of the grant project in December 2018. As of January 2019, the site has been visited by more than 7,500 individuals. NEBGH has been in contact with hospitals for their suggestions on how to boost engagement, but has not received substantive feedback to date. It has also conducted additional consumer focus groups and other outreach to gain further insights and encourage use of the website. NEBGH is exploring opportunities to expand ExpectNY statewide, but has not secured additional funding to date.

In May 2019, Yelp began a partnership with NEBGH to display information about the quality of maternity care for the hospitals in New York City and on Long Island. The Yelp pages for these hospitals are now using NEBGH’s ExpectNY metrics to show whether the facilities are above average, average, or below average in their rates of C-section deliveries in low-risk pregnancies; newborns being fed only breast milk before discharge; the administering of an episiotomy; and VBACs. The Yelp pages also include a link to ExpectNY, where users can get more information about the measures used for these hospitals.

Co-Funding and Additional Funds Leveraged: N/A