Perinatal Episode of Care Program
NJ FamilyCare’s Perinatal Episode of Care is a program to financially incentivize clinicians to take on comprehensive responsibility for the quality and cost of their patients’ maternity care. The program’s goal is to improve the quality of perinatal care delivered within NJ’s Medicaid and CHIP program (also known as NJ FamilyCare), while supporting the financial sustainability of the program.
NJ is also participating in the federal Transforming Maternal Health (TMaH) model (see January 2025 press release). A critical piece of the TMaH model will be creating a payment model for NJ FamilyCare maternity care providers, which is scheduled to launch in 2028. The episode program will be used to inform the design and implementation of NJ’s TMaH payment model.
The program began as a pilot pursuant to legislation passed in 2019 (P.L. 2019, c.86). The pilot was one component of NurtureNJ, a statewide initiative to make New Jersey the safest and most equitable place in the nation to deliver and raise a baby. The pilot included three Performance Periods—from April 1, 2022- June 30, 2025.
To contact NJ FamilyCare about the program, email mahs.maternityepisode@dhs.nj.gov.
Information for NJ FamilyCare Providers Interested in Participating in the Episode of Care Program
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 program by providers is voluntary. If your NJ FamilyCare practice is interested in participating, email mahs.maternityepisode@dhs.nj.gov to learn more.
There have been four Performance Periods of the program:
Program Performance Period 4 (12 months): July 1, 2025-June 30, 2026
Pilot Performance Period 3 (12 months): July 1, 2024-June 30, 2025
Pilot Performance Period 2 (12 months): July 1, 2023-June 30, 2024
Pilot Performance Period 1 (15 months): April 1, 2022-June 30, 2023
Information for NJ FamilyCare Members
The NJ FamilyCare obstetrical providers that are participating in the Episode of Care Program Performance Period 4 (July 1, 2025 to June 30, 2026) will be posted here when finalized.
The NJ FamilyCare obstetrical providers that participated in the Episode of Care Pilot Performance Period 3 (July 1, 2024 to June 30, 2025) can be found here.
The NJ FamilyCare obstetrical providers that participated in the Episode of Care Pilot Performance Period 2 (July 1, 2023 to June 30, 2024) can be found here.
The NJ FamilyCare obstetrical providers that participated in the Episode of Care Pilot Performance Period 1 (April 1, 2022 to June 30, 2023) can be found here.
Program Performance Period 4 (2025-2026) Information
Pilot Information
The design of NJ FamilyCare’s perinatal episode of care 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.
The Episode North Star Principles describes the overall goals and guided our implementation of the perinatal episode of care pilot.
Pilot Performance Period 3 (2024-2025) Information
Pilot Performance Period 2 (2023-2024) Information
Pilot Performance Period 1 (2022-2023) Information
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)
