IMPACT OF VIRTUAL MATERNITY PROGRAM ENGAGEMENT ON NEONATAL OUTCOMES AND COSTS IN A COMMERCIAL POPULATION
Author(s)
Lena Bertozzi, BA1, Madeline Perry, MD2, Adam Kubsh, BS1, Thomas Galeon, MS1, Shyamali Choudhury, BA, MPP1, Isabelle Von Kohorn, MD, PhD1, Ian J. Hooley, BS1.
1Pomelo Care, New York, NY, USA, 2Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
1Pomelo Care, New York, NY, USA, 2Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
OBJECTIVES: To evaluate the association between engagement duration in a multispecialty virtual maternity program and neonatal intensive care unit (NICU) utilization and costs. Applying peer-reviewed methodology from a prior clinical study, we evaluated a commercially insured population to assess how reductions in neonatal utilization may translate into episode-level cost impacts.
METHODS: In this retrospective cohort analysis, we analyzed commercial administrative claims for deliveries (n=6,017) between January 2023 and September 2025. The intervention provided 24/7 access to a multispecialty care team integrated with remote monitoring, urgent care, and NICU transition of care. Following established methodology, we applied inverse probability weighting and doubly-robust regression to compare outcomes across exposure thresholds (≥1, ≥2, and ≥3 months of prenatal engagement) against propensity-weighted unengaged comparators. We used models adjusted for demographics, clinical comorbidities, and prior utilization to evaluate the association between engagement and claims-derived NICU utilization. Observed utilization reductions were translated into estimated economic savings using standardized per diem rates.
RESULTS: Clinical and economic outcomes exhibited a dose-response relationship with duration of engagement with the clinician team. Total NICU days per delivery were reduced by 19.5% at ≥ 1month and 24.8% at ≥2 months, with a statistically significant 39.1% reduction at ≥3 months (p < 0.05). We observed supporting directional clinical reductions in the ≥3 months cohort for preterm birth risk (-21.6%) and NICU admission (-9.3%). When modeled using standardized per diem assumptions, these utilization reductions translated into a 39.1% decrease in total NICU spend for the cohort engaged for ≥3 months.
CONCLUSIONS: Sustained engagement in a clinically integrated virtual maternity program was associated with reproducible reductions in high-acuity neonatal utilization and associated costs in commercially insured populations. These findings suggest that virtual models may offer a scalable mechanism to reduce the high financial burden of neonatal care.
METHODS: In this retrospective cohort analysis, we analyzed commercial administrative claims for deliveries (n=6,017) between January 2023 and September 2025. The intervention provided 24/7 access to a multispecialty care team integrated with remote monitoring, urgent care, and NICU transition of care. Following established methodology, we applied inverse probability weighting and doubly-robust regression to compare outcomes across exposure thresholds (≥1, ≥2, and ≥3 months of prenatal engagement) against propensity-weighted unengaged comparators. We used models adjusted for demographics, clinical comorbidities, and prior utilization to evaluate the association between engagement and claims-derived NICU utilization. Observed utilization reductions were translated into estimated economic savings using standardized per diem rates.
RESULTS: Clinical and economic outcomes exhibited a dose-response relationship with duration of engagement with the clinician team. Total NICU days per delivery were reduced by 19.5% at ≥ 1month and 24.8% at ≥2 months, with a statistically significant 39.1% reduction at ≥3 months (p < 0.05). We observed supporting directional clinical reductions in the ≥3 months cohort for preterm birth risk (-21.6%) and NICU admission (-9.3%). When modeled using standardized per diem assumptions, these utilization reductions translated into a 39.1% decrease in total NICU spend for the cohort engaged for ≥3 months.
CONCLUSIONS: Sustained engagement in a clinically integrated virtual maternity program was associated with reproducible reductions in high-acuity neonatal utilization and associated costs in commercially insured populations. These findings suggest that virtual models may offer a scalable mechanism to reduce the high financial burden of neonatal care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE112
Topic
Clinical Outcomes, Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Pediatrics, Reproductive & Sexual Health