Abstract

INTRODUCTION: The Plan for Appropriate Tailored Healthcare in pregnancy (PATH) recommends tailoring prenatal visit schedules and modality (eg, telemedicine visits) to patients' risk factors and preferences. We simulated PATH recommendations to explore financial implications from the patient perspective. METHODS: In this IRB-exempt study, a dataset of 4,992 patients from a single academic health system was used to establish key assumptions for financial modeling. The model was constructed using several key parameters: patient risk, travel, and employment variables. We report patient-perspective cost and time savings across three models: traditional care (all patients seen for 12–14 in-person visits), tailored prenatal care (visit number tailored to patient risk), and hybrid tailored care (tailored care with telemedicine and in-person visits). RESULTS: Implementation of tailored care resulted in substantial cost and time savings. In the traditional model, average travel time was 26 hours and average total cost per patient was $1,374 (time off cost, $1,310; travel cost, $64). In the tailored model, patients saved on average 5 hours of travel time and $172 (total cost, $1,201; time off cost, $1,145; travel cost, $56). In the hybrid tailored model, patients saved on average 18 hours of travel and $792 (total cost, $581; time-off cost, $525; travel cost, $21; at-home supplies, $35). Extrapolated across all patients who sought prenatal care in 2020, estimated national cost savings range from approximately $0.5B and $2B annually for the in-person tailored and hybrid tailored model, respectively. CONCLUSION: Tailored prenatal care delivery policies, particularly those that include telemedicine, result in significant time and cost savings for patients.

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