Perinatal Episode of Care Pilot
NJ FamilyCare’s perinatal episode of care is a three-year pilot to test a new alternative payment model for prenatal, labor, and postpartum services statewide. Clinicians who choose to participate in the pilot are financially incentivized to take on comprehensive responsibility for the quality and cost of their patients’ care. The episode pilot will tie incentives to improvements in quality and cost of maternity-related care, from the prenatal period to 60 days postpartum. In addition to eligibility for additional financial incentives, providers who participate in the pilot will receive detailed personalized feedback on their performance and will undertake specific quality improvement activities.
The pilot’s goal is to improve the quality and equity of perinatal care delivered within NJ’s Medicaid and CHIP programs, while supporting the financial sustainability of the program.
The perinatal episode of care pilot is part of the maternal health reforms of NurtureNJ, a statewide campaign led by First Lady Tammy Murphy to make New Jersey the safest and most equitable place in the nation to deliver and raise a baby.
Information for NJ FamilyCare Providers Interested in Participating in the Episode of Care
Practices must provide obstetrical care for members enrolled in at least one of our NJ FamilyCare managed care organizations (MCOs) to be eligible to participate.
Participation in the pilot by providers is voluntary. Providers can choose to participate in any of the following three Performance Periods of the pilot:
Performance Period 1 (15 months): April 1, 2022-June 30, 2023
Performance Period 2 (12 months): July 1, 2023-June 30, 2024
Performance Period 3 (12 months): July 1, 2024-June 30, 2025
Performance Period 1 is underway and we are no longer accepting new participants. To see which NJ FamilyCare obstetrical providers are participating in Performance Period 1, see this list.
If you are interested in participating in Performance Period 2, please email mahs.maternityepisode@dhs.nj.gov and review the resources below.
Information for NJ FamilyCare Members
The NJ FamilyCare obstetrical providers participating in the Episode of Care Pilot Performance Period 1 (which runs from April 1, 2022 to June 30, 2023) can be found here.
Episode of Care Steering Committee
The design of NJ FamilyCare’s perinatal episode of care has benefited from the ongoing input of the Episode of Care Steering Committee. This group includes providers, hospital systems, managed care organizations, and state agencies. For more information about the work of the Steering Committee, please see Episode of Care Steering Committee.
Episode of Care North Star Principles
The Episode North Star Principles describes the overall goals of the pilot and guides our implementation of the perinatal episode of care.
Performance Period 1 Guide for Participating Providers: Appendix
Appendices for the Guide for Participating Providers:
Episode of Care Recorded Webinars
Webinar #1: Introduction to the NJ FamilyCare perinatal episode of care pilot (Original Session Date: 12/7/2021)
- Webinar 1 is a 45 minute presentation that covers the background on the pilot and describes key features of the perinatal episode of care for Performance Period 1.
- Presentation (video recording)
- Slide deck (PDF)
Webinar #2: NJ FamilyCare’s perinatal episode of care pilot: Pilot Launch Report (Original Session Date: 1/7/2022)
- Webinar 2 is a 45 minute presentation that covers how to read and interpret the data shared in the Episode Pilot Launch Report released to providers in December 2021. The information included in the Pilot Launch Report reflects what providers who choose to participate in the pilot will receive in Interim/Final Performance Period reports.
- Sample Pilot Launch Report
- Presentation (video recording)
- Slide deck (PDF)
