A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks
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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health 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FM","link":"/"}},"stateofhealth_362982":{"type":"posts","id":"stateofhealth_362982","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362982","score":null,"sort":[1522082717000]},"guestAuthors":[],"slug":"a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks","title":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks","publishDate":1522082717,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>While most of the recent debate around health care has been around cost -- especially the predictions about skyrocketing Obamacare premiums -- there are 100 pages in the Affordable Care Act devoted solely to improving the \u003ca href=\"https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/\" target=\"_blank\" rel=\"noopener\">\u003cem>quality \u003c/em>of the health care\u003c/a> Americans are paying so much for.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s Obamacare marketplace, is taking that mandate under the law seriously, and is now making a bold move to improve quality in a concrete way, and ultimately, ensure that California consumers get more value for their premium dollars.\u003c/p>\n\u003cp>In the next three-year contract that Covered California strikes with insurance companies, there will be a quality-focused stipulation: any hospital that doesn't meet certain targets for safety and quality can be excluded from the health plans sold through the marketplace.\u003c/p>\n\u003cp>“We’re saying ‘time’s up,’” said \u003ca href=\"https://www.bizjournals.com/sacramento/news/2015/05/22/covered-california-hires-chief-medical-officer.html\" target=\"_blank\" rel=\"noopener\">Lance Lang\u003c/a>, the chief medical officer for Covered California. “We’ve told health plans that by the end of 2019, we want networks to only include hospitals that have achieved that target.”\u003c/p>\n\u003cp>Lang says every hospital in California should be able to reach the quality targets, though some may need help identifying and fixing obstacles along the way. The chosen targets require hospitals to perform fewer unnecessary C-sections, reduce hospital-acquired infections, improve patient experience, and reduce excessive costs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For example, C-sections. Hospitals get paid more to do them, and they usually take less time: 40 minutes for a scheduled procedure versus 24-hour on-call staffing for vaginal deliveries. Although C-sections are often medically prudent when the mother or fetus has a high risk of complication, many women who don’t need a C-section often get one anyway. Even in low-risk cases, some California hospitals are delivering 70 percent of those babies by C-section.\u003c/p>\n\u003cp>“That means that when a woman goes to a hospital, it’s the culture of the hospital that really determines whether or not she gets a cesarean section, not so much her own health,” said Lang.\u003c/p>\n\u003cp>Unnecessary C-sections create unnecessary risks: infection, hemorrhage, even death. Babies delivered by C-section are more likely to have complications and spend more time in the neonatal intensive care unit.\u003c/p>\n\u003cp>That’s not quality health care, said Lang, and that’s why Covered California is telling hospitals they need to reduce their C-section rates to 23.9 percent or lower, for low-risk births. \"Low risk\" is defined as a healthy, first-time mom carrying a single baby with its head down, all the way to full term (\u003ca href=\"https://www.nichd.nih.gov/news/resources/spotlight/102413-redefining-term\" target=\"_blank\" rel=\"noopener\">39 weeks gestation\u003c/a>).\u003c/p>\n\u003cp>Covered California is joined by \u003ca href=\"https://www.coveredca.com/medi-cal/\" target=\"_blank\" rel=\"noopener\">Medi-Cal\u003c/a>, the state health program for low-income residents, \u003ca href=\"https://www.calpers.ca.gov/\" target=\"_blank\" rel=\"noopener\">CalPERS\u003c/a>, the retirement program for state employees, and the \u003ca href=\"http://www.pbgh.org/\" target=\"_blank\" rel=\"noopener\">Pacific Business Group on Health\u003c/a>, which represents self-insured employers. Together, these groups pay for the health care of 16 million Californians, or 40 percent of the state, which gives them substantial leverage with hospitals.\u003c/p>\n\u003cp>But only Covered California is telling hospitals that if don’t play by the rules, they’ll be benched.\u003c/p>\n\u003cp>“It’s probably the boldest move we’ve seen in maternity care ever,” said Leah Binder, CEO of the \u003ca href=\"http://www.leapfroggroup.org/\" target=\"_blank\" rel=\"noopener\">Leapfrog Group\u003c/a>, a Washington, DC-based nonprofit that rates hospitals on quality.\u003c/p>\n\u003cp>Quality control for hospitals is a recent phenomenon, and still largely voluntary, she said.\u003c/p>\n\u003cp>“Back in the '80s and '90s, nobody ever thought that hospitals should have to report to anyone on how they were doing,” she said. “There’s never been a culture of accountability.”\u003c/p>\n\u003cp>Covered California’s move is nationally significant, Binder said, given the consequences for hospitals, and the agency’s reach – 1.4 million people buy coverage through the marketplace, and they shop among plans offered by 11 state-approved insurance companies.\u003c/p>\n\u003cp>Insurers and business groups across the country are already keeping an eye on California’s effort, she said, to see how they might band together to demand similar change from the hospitals in their regions.\u003c/p>\n\u003cp>“The Northeast Business Group on Health, which covers New York and Massachusetts and Connecticut, they will definitely be watching this to see what could be done,” Binder said.\u003c/p>\n\u003cp>Overall, California’s hospitals are on board with the goal. Of the 243 maternity hospitals in the state, 40 percent have already met the target, Lang said, and another 40 percent have taken advantage of coaching and consulting, to help educate the doctors on how they can adjust their practice, and to educate patients who request C-sections about the risks.\u003c/p>\n\u003cp>“While many may prefer that, when having the full information about the risk that they may be putting themselves and their babies in, they elect not to move in that direction,” said Julie Morath, CEO of the \u003ca href=\"http://www.hqinstitute.org/\" target=\"_blank\" rel=\"noopener\">Hospital Quality Institute\u003c/a>, a subsidiary of the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>, both of which support the C-section reduction goals as “the right thing to do.”\u003c/p>\n\u003cp>The effort has raised some concerns among mothers who hear about the 23.9 percent target and worry about rationing.\u003c/p>\n\u003cp>“We don't just chase rates,” Morath said, in counter to that concern, “but rather look at what the clinical needs are and best respond to those. So if there is an indication for a cesarean section, the mother will receive a cesarean section.”\u003c/p>\n\u003cp>But the coaching, and the kind of system change and staffing levels that can be required to lower C-section rates, might be too costly for some hospitals. State data show there are about 40 hospitals that are still far off the target, including a cluster of hospitals in East Los Angeles that treat low-income, often uninsured, patients.\u003c/p>\n\u003cp>The target rate may not be fair for these hospitals, said Malini Nijagal, an OB/GYN at Zuckerberg San Francisco General Hospital. Her hospital’s C-section rate is already below the target, but she said it won’t be easy for others with more diverse patients.\u003c/p>\n\u003cp>“So if you have somebody who is on methamphetamines and is homeless and has not gotten any prenatal care, her chance of a C-section is way higher than someone who is not all those things,” she said. “And so the problem is, how do you adjust for the patient population of a hospital?”\u003c/p>\n\u003cp>At Memorial Hospital of Gardena, the C-section rate is 45.2 percent. At East Los Angeles Doctors Hospital, the rate is 48.1 percent, according to publicly-available state data listed on \u003ca href=\"http://calhospitalcompare.org/\" target=\"_blank\" rel=\"noopener\">CalHospital Compare\u003c/a> and \u003ca href=\"https://www.kqed.org/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals\" target=\"_blank\" rel=\"noopener\">Yelp\u003c/a>.\u003c/p>\n\u003cp>Both hospitals are working diligently to lower the rates, according to Amie Boersma, director for communications for \u003ca href=\"http://avantihospitals.com/\" target=\"_blank\" rel=\"noopener\">Avanti Hospitals\u003c/a>, which owns both hospitals.\u003c/p>\n\u003cp>She said the hospitals will meet the 23.9 percent benchmark and are committed to doing so for the sake of their patients. Being excluded from Covered California health plan networks, she added, would make it even more difficult for those patients to get care. They would either have to pay \"out-of-network\" fees to be seen there, or they would have to travel farther to another facility that was still in the network.\u003c/p>\n\u003cp>“We are in under-served, economically challenged urban neighborhoods and it is vitally important that we continue to provide appropriate, high-quality care for our communities,” Boersma said.\u003c/p>\n\u003cp>Health plans can request exceptions to Covered California’s contract rules, in order to keep non-complying hospitals in their networks, as long as they document their reasoning.\u003c/p>\n\u003cp>“That is flexibility that we asked for to ensure that we maintain adequate access to providers,” said Charles Bacchi, CEO of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\" rel=\"noopener\">California Association of Health Plans\u003c/a>, a trade group for insurers. “Any major changes to health plan networks must be filed with regulators, and health plans have to ensure that patients continue to receive services in a timely manner.”\u003c/p>\n\u003cp>So far, the prospect of exclusion, plus the coaching and education, have functioned as an effective motivator. By the 2020 deadline, Covered California’s Dr. Lang believes all hospitals will either have met the target or be on their way. While the consequences are real, and while it may take some awkward conversations to get there, he said the ultimate goal is to get hospitals to deliver better, safer care to patients.\u003c/p>\n\u003cp>“It's a quality improvement project,” Lang said, “but with a deadline.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CORRECTION: An earlier version of this story incorrectly listed the quality-care targets hospitals would have to meet to be included in Covered California insurance plans. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Covered California, the state's insurance marketplace, has been actively focused on cost control for years. Now the agency is demanding more on quality measures such as C-section rates and hospital-acquired infections. ","status":"publish","parent":0,"modified":1534298703,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1464},"headData":{"title":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks | KQED","description":"Covered California, the state's insurance marketplace, has been actively focused on cost control for years. Now the agency is demanding more on quality measures such as C-section rates and hospital-acquired infections. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"362982 https://ww2.kqed.org/stateofhealth/?p=362982","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/03/26/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks/","disqusTitle":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/03/DemboskyHospitalQuality.mp3","audioTrackLength":214,"path":"/stateofhealth/362982/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>While most of the recent debate around health care has been around cost -- especially the predictions about skyrocketing Obamacare premiums -- there are 100 pages in the Affordable Care Act devoted solely to improving the \u003ca href=\"https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/\" target=\"_blank\" rel=\"noopener\">\u003cem>quality \u003c/em>of the health care\u003c/a> Americans are paying so much for.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s Obamacare marketplace, is taking that mandate under the law seriously, and is now making a bold move to improve quality in a concrete way, and ultimately, ensure that California consumers get more value for their premium dollars.\u003c/p>\n\u003cp>In the next three-year contract that Covered California strikes with insurance companies, there will be a quality-focused stipulation: any hospital that doesn't meet certain targets for safety and quality can be excluded from the health plans sold through the marketplace.\u003c/p>\n\u003cp>“We’re saying ‘time’s up,’” said \u003ca href=\"https://www.bizjournals.com/sacramento/news/2015/05/22/covered-california-hires-chief-medical-officer.html\" target=\"_blank\" rel=\"noopener\">Lance Lang\u003c/a>, the chief medical officer for Covered California. “We’ve told health plans that by the end of 2019, we want networks to only include hospitals that have achieved that target.”\u003c/p>\n\u003cp>Lang says every hospital in California should be able to reach the quality targets, though some may need help identifying and fixing obstacles along the way. The chosen targets require hospitals to perform fewer unnecessary C-sections, reduce hospital-acquired infections, improve patient experience, and reduce excessive costs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For example, C-sections. Hospitals get paid more to do them, and they usually take less time: 40 minutes for a scheduled procedure versus 24-hour on-call staffing for vaginal deliveries. Although C-sections are often medically prudent when the mother or fetus has a high risk of complication, many women who don’t need a C-section often get one anyway. Even in low-risk cases, some California hospitals are delivering 70 percent of those babies by C-section.\u003c/p>\n\u003cp>“That means that when a woman goes to a hospital, it’s the culture of the hospital that really determines whether or not she gets a cesarean section, not so much her own health,” said Lang.\u003c/p>\n\u003cp>Unnecessary C-sections create unnecessary risks: infection, hemorrhage, even death. Babies delivered by C-section are more likely to have complications and spend more time in the neonatal intensive care unit.\u003c/p>\n\u003cp>That’s not quality health care, said Lang, and that’s why Covered California is telling hospitals they need to reduce their C-section rates to 23.9 percent or lower, for low-risk births. \"Low risk\" is defined as a healthy, first-time mom carrying a single baby with its head down, all the way to full term (\u003ca href=\"https://www.nichd.nih.gov/news/resources/spotlight/102413-redefining-term\" target=\"_blank\" rel=\"noopener\">39 weeks gestation\u003c/a>).\u003c/p>\n\u003cp>Covered California is joined by \u003ca href=\"https://www.coveredca.com/medi-cal/\" target=\"_blank\" rel=\"noopener\">Medi-Cal\u003c/a>, the state health program for low-income residents, \u003ca href=\"https://www.calpers.ca.gov/\" target=\"_blank\" rel=\"noopener\">CalPERS\u003c/a>, the retirement program for state employees, and the \u003ca href=\"http://www.pbgh.org/\" target=\"_blank\" rel=\"noopener\">Pacific Business Group on Health\u003c/a>, which represents self-insured employers. Together, these groups pay for the health care of 16 million Californians, or 40 percent of the state, which gives them substantial leverage with hospitals.\u003c/p>\n\u003cp>But only Covered California is telling hospitals that if don’t play by the rules, they’ll be benched.\u003c/p>\n\u003cp>“It’s probably the boldest move we’ve seen in maternity care ever,” said Leah Binder, CEO of the \u003ca href=\"http://www.leapfroggroup.org/\" target=\"_blank\" rel=\"noopener\">Leapfrog Group\u003c/a>, a Washington, DC-based nonprofit that rates hospitals on quality.\u003c/p>\n\u003cp>Quality control for hospitals is a recent phenomenon, and still largely voluntary, she said.\u003c/p>\n\u003cp>“Back in the '80s and '90s, nobody ever thought that hospitals should have to report to anyone on how they were doing,” she said. “There’s never been a culture of accountability.”\u003c/p>\n\u003cp>Covered California’s move is nationally significant, Binder said, given the consequences for hospitals, and the agency’s reach – 1.4 million people buy coverage through the marketplace, and they shop among plans offered by 11 state-approved insurance companies.\u003c/p>\n\u003cp>Insurers and business groups across the country are already keeping an eye on California’s effort, she said, to see how they might band together to demand similar change from the hospitals in their regions.\u003c/p>\n\u003cp>“The Northeast Business Group on Health, which covers New York and Massachusetts and Connecticut, they will definitely be watching this to see what could be done,” Binder said.\u003c/p>\n\u003cp>Overall, California’s hospitals are on board with the goal. Of the 243 maternity hospitals in the state, 40 percent have already met the target, Lang said, and another 40 percent have taken advantage of coaching and consulting, to help educate the doctors on how they can adjust their practice, and to educate patients who request C-sections about the risks.\u003c/p>\n\u003cp>“While many may prefer that, when having the full information about the risk that they may be putting themselves and their babies in, they elect not to move in that direction,” said Julie Morath, CEO of the \u003ca href=\"http://www.hqinstitute.org/\" target=\"_blank\" rel=\"noopener\">Hospital Quality Institute\u003c/a>, a subsidiary of the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>, both of which support the C-section reduction goals as “the right thing to do.”\u003c/p>\n\u003cp>The effort has raised some concerns among mothers who hear about the 23.9 percent target and worry about rationing.\u003c/p>\n\u003cp>“We don't just chase rates,” Morath said, in counter to that concern, “but rather look at what the clinical needs are and best respond to those. So if there is an indication for a cesarean section, the mother will receive a cesarean section.”\u003c/p>\n\u003cp>But the coaching, and the kind of system change and staffing levels that can be required to lower C-section rates, might be too costly for some hospitals. State data show there are about 40 hospitals that are still far off the target, including a cluster of hospitals in East Los Angeles that treat low-income, often uninsured, patients.\u003c/p>\n\u003cp>The target rate may not be fair for these hospitals, said Malini Nijagal, an OB/GYN at Zuckerberg San Francisco General Hospital. Her hospital’s C-section rate is already below the target, but she said it won’t be easy for others with more diverse patients.\u003c/p>\n\u003cp>“So if you have somebody who is on methamphetamines and is homeless and has not gotten any prenatal care, her chance of a C-section is way higher than someone who is not all those things,” she said. “And so the problem is, how do you adjust for the patient population of a hospital?”\u003c/p>\n\u003cp>At Memorial Hospital of Gardena, the C-section rate is 45.2 percent. At East Los Angeles Doctors Hospital, the rate is 48.1 percent, according to publicly-available state data listed on \u003ca href=\"http://calhospitalcompare.org/\" target=\"_blank\" rel=\"noopener\">CalHospital Compare\u003c/a> and \u003ca href=\"https://www.kqed.org/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals\" target=\"_blank\" rel=\"noopener\">Yelp\u003c/a>.\u003c/p>\n\u003cp>Both hospitals are working diligently to lower the rates, according to Amie Boersma, director for communications for \u003ca href=\"http://avantihospitals.com/\" target=\"_blank\" rel=\"noopener\">Avanti Hospitals\u003c/a>, which owns both hospitals.\u003c/p>\n\u003cp>She said the hospitals will meet the 23.9 percent benchmark and are committed to doing so for the sake of their patients. Being excluded from Covered California health plan networks, she added, would make it even more difficult for those patients to get care. They would either have to pay \"out-of-network\" fees to be seen there, or they would have to travel farther to another facility that was still in the network.\u003c/p>\n\u003cp>“We are in under-served, economically challenged urban neighborhoods and it is vitally important that we continue to provide appropriate, high-quality care for our communities,” Boersma said.\u003c/p>\n\u003cp>Health plans can request exceptions to Covered California’s contract rules, in order to keep non-complying hospitals in their networks, as long as they document their reasoning.\u003c/p>\n\u003cp>“That is flexibility that we asked for to ensure that we maintain adequate access to providers,” said Charles Bacchi, CEO of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\" rel=\"noopener\">California Association of Health Plans\u003c/a>, a trade group for insurers. “Any major changes to health plan networks must be filed with regulators, and health plans have to ensure that patients continue to receive services in a timely manner.”\u003c/p>\n\u003cp>So far, the prospect of exclusion, plus the coaching and education, have functioned as an effective motivator. By the 2020 deadline, Covered California’s Dr. Lang believes all hospitals will either have met the target or be on their way. While the consequences are real, and while it may take some awkward conversations to get there, he said the ultimate goal is to get hospitals to deliver better, safer care to patients.\u003c/p>\n\u003cp>“It's a quality improvement project,” Lang said, “but with a deadline.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>CORRECTION: An earlier version of this story incorrectly listed the quality-care targets hospitals would have to meet to be included in Covered California insurance plans. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362982/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_15","stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_38","stateofhealth_3138","stateofhealth_368","stateofhealth_2808","stateofhealth_3231","stateofhealth_2519","stateofhealth_365"],"featImg":"stateofhealth_363029","label":"stateofhealth"},"stateofhealth_358760":{"type":"posts","id":"stateofhealth_358760","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"358760","score":null,"sort":[1501119386000]},"guestAuthors":[],"slug":"yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","title":"Yelp Wants to Help You With Your Birth Plan","publishDate":1501119386,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>You may check Yelp reviews before deciding where to go to dinner, or which plumber to hire. Now you can use Yelp to decide where to have a baby.\u003c/p>\n\u003cp>The San Francisco-based review site is now adding clinical data on C-sections, episiotomies, and breastfeeding rates to consumer reviews of California hospitals, so women can make more informed decisions about where they deliver.\u003c/p>\n\u003cp>“Just like they're using that kind of information to buy a car, they should be using it to think about where they're getting their health care,” says \u003ca href=\"http://www.chcf.org/about/staff/stephanie-teleki\" target=\"_blank\" rel=\"noopener noreferrer\">Stephanie Teleki\u003c/a>, director of evaluation and impact at the California Health Care Foundation.\u003c/p>\n\u003cp>A woman’s chance of having a C-section depends, in part, on where she delivers, Teleki explains. The more C-sections a hospital does, the more likely a woman delivering there will have one.\u003c/p>\n\u003cp>That’s why the Foundation is partnering with Yelp to publish C-section rates for every hospital in the state - nearly 250 total.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-27d-tcr.mp3\" Image=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/08/RS19268_IMG_6407-qut-768x576.jpg\" Title=\"Yelp Adds C-Section Rates and Childbirth Data to Reviews of California Hospitals\" program=\"The California Report\"]\u003c/p>\n\u003cp>Shannon Eis, vice president of communications at Yelp, says this would have been helpful information to have when she gave birth to her son in New York. It was her second baby, everything felt normal, when all of a sudden alarms started going off and she was rushed into an emergency C-section.\u003c/p>\n\u003cp>“I had never considered myself a C-section risk,” she says. \"I later found out I gave birth at a hospital that has the highest emergency C-section rate in all of New York City.”\u003c/p>\n\u003cp>Eis says putting this data on Yelp will help women choose a hospital that is aligned with their birth plan, so they won’t have to negotiate with doctors and make tough choices while they’re in labor.\u003c/p>\n\u003cp>“All these decisions are washing over you so fast, and so if you haven't done the research to put yourself in the right environment, where whatever your decisions are can be honored without the tremendous pressure and fear – women are trying to do more planning around that,” she says.\u003c/p>\n\u003cp>The reaction from the state's hospital industry group was low-key.\u003c/p>\n\u003cp>“We have always supported transparency - this effort simply takes it more directly to consumers,” says Jan Emerson-Shea, from the California Hospital Association. “We'll have to see how it works.”\u003c/p>\n\u003cp>When the data first went public on government and foundation websites a few years ago, hospitals generally responded by trying to improve care for women, Teleki says. But she’s curious to see how hospitals will respond when those statistics are put right in front of consumers, through the online megaphone of Yelp.\u003c/p>\n\u003cp>“For hospitals that are doing well, that’s a good thing,” she says. “For hospitals that need to improve, I'm sure they will feel some heat and perhaps be discouraged about the release.”\u003c/p>\n\u003cp>California is the first state where Yelp is rolling out this data. With one in eight babies born in the US born here, Eis says it’s the perfect place to test the product before rolling it out to other states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If the state of California can do this with the biggest data set in the country, the biggest birthrate in the country, any other state can do it,” she said.\u003c/p>\n\n","blocks":[],"excerpt":"Now pregnant women can review C-section and episiotomy rates before deciding where to have their baby.","status":"publish","parent":0,"modified":1501202295,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":622},"headData":{"title":"Yelp Wants to Help You With Your Birth Plan | KQED","description":"Now pregnant women can review C-section and episiotomy rates before deciding where to have their baby.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"358760 https://ww2.kqed.org/stateofhealth/?p=358760","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/07/26/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals/","disqusTitle":"Yelp Wants to Help You With Your Birth Plan","path":"/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You may check Yelp reviews before deciding where to go to dinner, or which plumber to hire. Now you can use Yelp to decide where to have a baby.\u003c/p>\n\u003cp>The San Francisco-based review site is now adding clinical data on C-sections, episiotomies, and breastfeeding rates to consumer reviews of California hospitals, so women can make more informed decisions about where they deliver.\u003c/p>\n\u003cp>“Just like they're using that kind of information to buy a car, they should be using it to think about where they're getting their health care,” says \u003ca href=\"http://www.chcf.org/about/staff/stephanie-teleki\" target=\"_blank\" rel=\"noopener noreferrer\">Stephanie Teleki\u003c/a>, director of evaluation and impact at the California Health Care Foundation.\u003c/p>\n\u003cp>A woman’s chance of having a C-section depends, in part, on where she delivers, Teleki explains. The more C-sections a hospital does, the more likely a woman delivering there will have one.\u003c/p>\n\u003cp>That’s why the Foundation is partnering with Yelp to publish C-section rates for every hospital in the state - nearly 250 total.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-27d-tcr.mp3","image":"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/08/RS19268_IMG_6407-qut-768x576.jpg","title":"Yelp Adds C-Section Rates and Childbirth Data to Reviews of California Hospitals","program":"The California Report","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shannon Eis, vice president of communications at Yelp, says this would have been helpful information to have when she gave birth to her son in New York. It was her second baby, everything felt normal, when all of a sudden alarms started going off and she was rushed into an emergency C-section.\u003c/p>\n\u003cp>“I had never considered myself a C-section risk,” she says. \"I later found out I gave birth at a hospital that has the highest emergency C-section rate in all of New York City.”\u003c/p>\n\u003cp>Eis says putting this data on Yelp will help women choose a hospital that is aligned with their birth plan, so they won’t have to negotiate with doctors and make tough choices while they’re in labor.\u003c/p>\n\u003cp>“All these decisions are washing over you so fast, and so if you haven't done the research to put yourself in the right environment, where whatever your decisions are can be honored without the tremendous pressure and fear – women are trying to do more planning around that,” she says.\u003c/p>\n\u003cp>The reaction from the state's hospital industry group was low-key.\u003c/p>\n\u003cp>“We have always supported transparency - this effort simply takes it more directly to consumers,” says Jan Emerson-Shea, from the California Hospital Association. “We'll have to see how it works.”\u003c/p>\n\u003cp>When the data first went public on government and foundation websites a few years ago, hospitals generally responded by trying to improve care for women, Teleki says. But she’s curious to see how hospitals will respond when those statistics are put right in front of consumers, through the online megaphone of Yelp.\u003c/p>\n\u003cp>“For hospitals that are doing well, that’s a good thing,” she says. “For hospitals that need to improve, I'm sure they will feel some heat and perhaps be discouraged about the release.”\u003c/p>\n\u003cp>California is the first state where Yelp is rolling out this data. With one in eight babies born in the US born here, Eis says it’s the perfect place to test the product before rolling it out to other states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If the state of California can do this with the biggest data set in the country, the biggest birthrate in the country, any other state can do it,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_2407","stateofhealth_2746"],"tags":["stateofhealth_3138","stateofhealth_2808","stateofhealth_3137","stateofhealth_2519","stateofhealth_2563"],"featImg":"stateofhealth_359030","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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