FIRST 1,000 DAYS CORE STRATEGY SPOTLIGHT
Expanding Relationship-based Group Healthcare to Improve Outcomes for Mothers, Babies, and Families
“We need to shift our thinking that caregivers are not knowledgeable. They understand their circumstances better than anyone else and have knowledge and experiences they can share. Increasing their ability to self-advocate and feel confident enables them to use the knowledge they have. Within a group model like CenteringPregnancy, caregivers (i.e., participants) are experts. They ask questions and answer each other’s questions.”
Developed over 20 years ago by a nurse midwife, Centering Healthcare Institute (CHI) is the leader in group-based healthcare that offers innovative ways to achieve the Quadruple Aim: improve health, lower healthcare costs, decrease burnout among providers, and enhance the care experience for patients – all within the framework of a billable visit.
Centering brings together 8-12 expectant mothers for prenatal care (CenteringPregnancy) or 6-8 families and their newborns during well-child visits up to age 2 (CenteringParenting). These two-hour group sessions include the individual health assessments one would expect at a doctor’s visit. But they go much further, with a facilitated group discussion among patients and providers on a variety of topics that might range from stress management and breastfeeding to safe sleep and infant cues. Beyond spending more time with their provider compared to a typical 15-minute visit, patients build a community of learning and support with peers who share advice and guidance. By design, Centering creates a dynamic in which patients and providers become true partners.
The Burke Foundation joined the New Jersey Department of Health, the Henry and Marilyn Taub Foundation, and The Nicholson Foundation, to invest in a five-site Centering pilot in 2019-2021. Despite launching groups during the disruption wrought by the COVID-19 pandemic, the sites served 153 families during a one-year implementation phase and had such encouraging results as:
- 30.3% fewer preterm births
- 26.2% fewer low birthweight newborns
- 8.9% higher breastfeeding rate at hospital discharge
- 40% more young children up-to-date on immunizations
Based on the pilot’s success, we are expanding Centering to 50 sites across New Jersey, which will serve 7,300 pregnant women and 5,100 babies through 2026 in areas of highest need.
In 2021, we selected 9 new expansion sites across 6 counties, including large urban hospitals, Federally Qualified Health Centers, and private physician practices. In addition to two years of support from CHI for planning, training, implementation advising, materials, and site accreditation, each site receives a startup grant to assist with operational costs (medical supplies and group space enhancements, for example). An evaluation is planned as part of this scaling effort to guide continuous quality improvement and a state-based backbone organization will be established to support sustainability.
Centering reduces the risk of a NICU stay by 28%.
CenteringPregnancy reduces the risk of preterm births by 38%.
Black women are significantly less likely to have preterm births in CenteringPregnancy’s group prenatal care model (10%) compared to traditional care (15.8%).
Learn more about how Centering sites creatively adjusted to either 100% telehealth or a hybrid care delivery approach to continue serving their patients during the COVID-19 pandemic in our blog post on Health Affairs GrantWatch, “Lessons From The Field: Offering Group Prenatal Care Via Telehealth During The COVID-19 Pandemic.”
Program in Action
