Blood Pressure and Pregnant Moms

If we focus on blood pressure, we can cut death rates overnight by giving patients more tools today; and incidentally, dramatically reduce the costs to health systems resulting from preeclampsia, preterm birth (directly correlated to preeclampsia), readmissions, and other costly complications related to hypertension.

Remote blood pressure monitoring can also begin to solve some of the larger structural issues at play in maternal health care. The use of remote tools can extend the reach of overburdened physicians and provide access to care for women living in maternity care deserts. It can also address racial inequities in the system. The benefits of monitoring blood pressure during pregnancy have staying power. With good habits around blood pressure developed during pregnancy, women are more likely to continue to watch and learn about their blood pressure trends throughout their lives. Pregnancy is often a woman's first encounter with the health care system, and an ideal time to solidify good habits and behaviors.

So what's holding us back from wide scale adoption of remote blood pressure monitoring?

Providing a blood pressure cuff to every single pregnant person would cost upwards of $200 million — a steep price, yes. But compared to nearly $3 billion dollars in cost associated with preeclampsia? The $13 billion plus for preterm birth (a result of 15% of preeclamptic pregnancies)? The $500 million in readmission costs for postpartum hypertension? And those costs don't take into account the massive downstream societal costs of maternal death and morbidity.

Of course the blood pressure cuff is only a part of the solution. Data is only as effective as the infrastructure that makes it actionable. We need to invest in infrastructure that communicates that data back to stakeholders (in this case, clinicians) in actionable ways — infrastructure that supports diagnostic data, integrates clinical protocols, functions within existing workflows and communicates across different data platforms.

This infrastructure already exists, and has only become more sophisticated with the advent of the Internet of Things, but health care industry standards are stuck in the past, and they need to adapt to incorporate and support it.

Payers can play a major role in encouraging these industry shifts — several years ago, Medicare unbundled remote patient monitoring reimbursement and is now fully supporting the use of digital tools to provide access to care for its patient population.

So why are commercial payers and Medicaid lagging behind? The pandemic has accelerated the inevitable shift to a more virtual model of care, and payers are in a position to cement that shift and affect immediate improvements on the system. We need widespread adoption of CPT codes, or new codes specifically designed for maternal health monitoring.

Congress has been proactive in proposing initiatives for improving maternal health, but the question of reimbursement is a major hurdle that they have yet to address. Any legislation directed to improvements in maternal health needs to include bottom-line incentives for providers — and incorporating the payer is a way to do that effectively.

Juan Pablo Segura is the president and co-founder of Babyscripts, a company that provides internet-enabled pregnancy support services.

(Photo: Shutterstock)