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Performance-Based Maternity Payments

Value-based initiatives, authorized by the National Defense Authorization Act for Fiscal Year 2016, seek to reward better health outcomes, enhance beneficiaries’ experience of care, and reduce health care costs over time. TRICARE has implemented the Performance-Based Maternity Payment Pilot, a value-based initiative that seeks to improve health outcomes for mothers and babies through an increased emphasis on maternity care quality in the TRICARE networks. 

The Leapfrog Group, a national nonprofit organization established to drive improvements in health care quality and safety, conducts an annual hospital survey and compares reported hospital performance against nationally-recognized benchmarks for five maternity care measures (early elective deliveries, C-sections, episiotomies, maternity care processes, and high-risk deliveries). Applicable providers will be awarded a rating based upon the most current survey data posted by The Leapfrog Group. 

Maternity Care Measure Resources

Early Elective Deliveries

Cesarean Sections 

Episiotomies

Maternity Care Processes

High-Risk Deliveries

  • High-Risk Deliveries data by hospital on nationally standardized metrics collaboration between Castlight Health and The Leapfrog Group.

Visit The Leapfrog Group's Maternity Care page to learn more about these measures and their latest hospital performance report.

Incentive Payments

Hospitals who participate in The Leapfrog Group’s survey are eligible for annual incentive payments. 

  • High Value = 2 percent
  • Value = 1 percent
  • High-Risk Delivery = an additional 1 percent

The Defense Health Agency is responsible for calculating incentive payments. Incentive cycles are as follows:

  • Incentive Cycle 1: Calculated Aug. 1, 2019, based on The Leapfrog Group rating as of Aug. 1, 2019 (for dates of service between Sept 1, 2018 and Dec. 31, 2018)
  • Incentive Cycle 2: Calculated Aug. 1, 2020, based on The Leapfrog Group rating as of Aug. 1, 2020 (for dates of service between Jan. 1, 2019 and Dec. 31, 2019)
  • Incentive Cycle 3: Calculated Aug. 1, 2021, based on The Leapfrog Group rating as of Aug. 1, 2021 (for dates of service between Jan. 1, 2020 and Dec. 31, 2020)

Participation in The Leapfrog Group’s survey is voluntary; however, only hospitals that participate in the survey are eligible for incentives. HNFS’ network provider directory identifies those providers awarded with a rating of High Value, Value or High-Risk Delivery with a corresponding icon (gold stork, green stork, pregnant woman), based upon the most current survey data posted by The Leapfrog Group on its public website. 

Survey Time Frames

The Leapfrog Group survey opens every year on April 1. Surveys that are completed by June 30 are published on July 25; however, the latest submission deadline is November 30 to be considered for the Spring Leapfrog Hospital Safety Grade. Visit The Leapfrog Group’s Deadline page to learn more. 

To learn more about The Leapfrog Group and survey participation, scoring and results, please visit www.leapfroggroup.org.