{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:40:36Z","timestamp":1785890436673,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T00:00:00Z","timestamp":1558051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A recent Center for Medicare and Medicaid Innovation report evaluated the four\u2010year Strong Start for Mothers and Newborns Initiative, which sought to improve maternal and newborn outcomes through exploration of three enhanced, evidence\u2010based care models. This paper reports the socio\u2010demographic characteristics, care processes, and outcomes for mothers and newborns engaged in care with American Association of Birth Centers (AABC) sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors examined data for 6424 Medicaid or Children's\u00a0Health Insurance Program (CHIP) beneficiaries in birth center care who gave birth between 2013 and 2017. Using data from the AABC Perinatal Data Registry\u2122, descriptive statistics were used to evaluate socio\u2010behavioral and medical risks, and core perinatal quality outcomes. Comparisons are made between outcomes in the AABC sample and national data during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Childbearing mothers enrolled at AABC sites had diverse socio\u2010behavioral risk factors similar to the national profile. The AABC sites exceeded national quality benchmarks for low birthweight (3.28%), preterm birth (4.42%), and primary cesarean birth (8.56%). Racial disparities in perinatal indicators were present within the Strong Start sample; however, they were at narrower margins than in national data. The enhanced model of care was notable for use of midwifery\u2010led prenatal, labor, and birth care and decreased hospital admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Birth center care improves population health, patient experience, and value. The model demonstrates the potential to decrease racial disparity and improve population health. Reduction of regulatory barriers and implementation of sustainable reimbursement are warranted to move the model to scale for Medicaid beneficiaries nationwide.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12433","type":"journal-article","created":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T01:51:01Z","timestamp":1558144261000},"page":"234-243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Strong Start in birth centers: Socio\u2010demographic characteristics, care processes, and outcomes for mothers and newborns"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-3789","authenticated-orcid":false,"given":"Jill","family":"Alliman","sequence":"first","affiliation":[{"name":"Frontier Nursing University Hyden Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Stapleton","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers Perkiomenville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Wright","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers Perkiomenville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Bauer","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers Perkiomenville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Slider","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers Perkiomenville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-9179","authenticated-orcid":false,"given":"Diana","family":"Jolles","sequence":"additional","affiliation":[{"name":"Frontier Nursing University Hyden Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2013.06.006"},{"key":"e_1_2_7_3_1","unstructured":"HillI DubayL CourtotB et al.Strong start for mothers and newborns evaluation: year 5 project synthesis Vol 1.https:\/\/downloads.cms.gov\/files\/cmmi\/strongstart-prenatal-finalevalrpt-v1.pdf. 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