Between fertility struggles, an increasing maternal mortality rate, and a lack of postpartum mental health support, it can be challenging to start a family in the United States today. And as less households fall under the traditional definition of family today, the need for health care tailored to the individual is evident.

Point32Health — the parent company of Harvard Pilgrim Health Care and Tufts Health Plan — is tackling family benefits and planning head-on through innovative collaborations and inclusive solutions.

Advancing health equity at the community level

Creating a more equitable health system is a top priority at Point32Health, and addressing disparities in maternal care is crucial to this work. Since the combination of Harvard Pilgrim and Tufts Health Plan in 2021, Point32Health has introduced several programs throughout New England that address social determinants of health that are focused on improving maternal health outcomes. 

Its collaboration with Meals on Wheels of Rhode Island helps broaden access to healthy and nutritious meals for pregnant women at Women & Infants Hospital. Through its collaboration with Boston Medical Center (BMC), Point32Health increases the quality of care for mothers negatively impacted by social determinants of health by adding additional quality measures, implementing a different payment model to incentivize better maternal outcomes, and providing additional funding to BMC’s Health Equity Accelerator. When looking at benefit design, Harvard Pilgrim’s family-centered care approach offers benefits that are inclusive to the modern family. 

Insurers who innovate

“Historically, insurers are not known for being fast or cutting-edge. Point32Health is committed to changing this perception through the work of our clinical innovation team,” says Point32Health’s chief medical officer, Glenn Pomerantz, MD. “We are the only health plan to serve members regardless of age and circumstance, which makes us well-suited to address their unique needs through innovative solutions.”

Point32Health’s clinical innovation team, led by Vice President Kate Wallis, is devoted to discovering and bringing new ideas to life to improve health outcomes. With strong program management, and analytical and clinical expertise, her team’s diverse professional backgrounds create the perfect formula for finding equitable and impactful health solutions.

“Health care can be very fragmented and we’re a piece of the puzzle. We’re the payer, but we need to understand the voice of the customer — the customer being our members, our providers, our accounts, and our employers. It’s about understanding how we can all come together to defragment care, to help our members improve health outcomes — and one of the areas we’re aiming to improve is maternal health,” Wallis says.  

Emerging programs are a first step to improving inequities

The team’s clinical and payer experience helps inform which opportunities are explored for consideration. Also, their collaboration with Point32Health colleagues and health care industry thought leaders creates space for different ideas and perspectives to develop. While some may categorize an emerging solution as experimental just because of how new it is, the clinical innovation team doesn’t shy away from new. Instead, through extensive analysis of real-world data, they aim to better understand how the emerging solution can benefit members. 

“We have a great opportunity to implement different emerging technologies but design them in a way that we’re able to get robust outcome metrics,” Wallis shares. “This allows us to then evaluate whether we want to more broadly cover them for our membership in the longer term.”

One example of a program that’s becoming widely adopted in the maternal health space has been the clinical innovation team’s collaboration with Ariadne Labs. TeamBirth, which is its care process innovation program, helps to improve the safety, dignity, and equity of childbirth by structuring essential information that should be communicated during every labor assessment. After a successful pilot program with UMass Memorial Medical Center, the collaboration with TeamBirth recently expanded, allowing for implementation at nine hospitals across Massachusetts. 

A maternal health offering for a new year

Striving for a similar outcome, the clinical innovation team has recently collaborated with Maven Clinic, the world’s largest virtual clinic for women’s and family health. Eligible Point32Health members and employees will have 24/7 access to board-certified reproductive endocrinologists (fertility doctors), obstetricians, gynecologists, nutritionists, mental health providers, adoption coaches, and other care providers who will advise participants at no additional cost.  

“Just as health care is not one-size-fits-all, there is not a one-size-fits-all approach to starting a family,” Pomerantz says. “Teaming up with Maven enables our team to provide more equitable access to family building, pregnancy, and postpartum care for our members. We are proud to offer this program to eligible members to help guide them through often complicated processes like exploring fertility treatments, navigating benefits, and postpartum care — making the entire journey more seamless and cost-effective.” 

Like TeamBirth, the goal of the Maven Clinic collaboration is to expand access across Point32Health’s member population and ultimately help improve maternal health outcomes in New England. Wallis is excited to continue implementing innovative programs with like-minded collaborators this year. “These collaborations across the enterprise mean so much to us,” she shares. “Every program makes a difference in maternal health outcomes and brings us one step closer to equitable and inclusive care for all.” 

Point32Health is a not-for-profit health and well-being organization, guiding and empowering healthier lives for all. Throughout all of life’s stages and challenges, our family of companies inclusive of Harvard Pilgrim Health Care and Tufts Health Plan support members and their families with whole-health benefits and solutions. Learn more about maternal health efforts with Point32Health and in our communities.