IMPACT OF A VIRTUAL MATERNITY PROGRAM ON POPULATION-LEVEL NICU UTILIZATION: A LONGITUDINAL YEAR-OVER-YEAR ANALYSIS
Author(s)
Lena Bertozzi, BA, Hannah Strader, BS, MS, Thomas Galeon, MS, Adam Kubsh, BS, Isabelle Von Kohorn, MD, PHD, Ian J. Hooley, BS.
Pomelo Care, New York, NY, USA.
Pomelo Care, New York, NY, USA.
OBJECTIVES: To evaluate changes in neonatal intensive care unit (NICU) utilization over a two-year period following the implementation of a US virtual maternity program and assess whether outcomes among prenatally engaged members were associated with population-level reductions in utilization and healthcare costs.
METHODS: This retrospective cohort analysis included all deliveries (N=11,601) from a commercially insured population between September 2023 and November 2025. Claims-derived NICU days per 1,000 deliveries and NICU admission rates were compared across three periods: baseline year pre-implementation, Year 1, and Year 2 post-implementation. Outcomes for the overall population were compared with a cohort that engaged prenatally with the 24/7 virtual maternity clinical team. Two-proportion z-tests were used to assess differences in cohort comorbidities.
RESULTS: NICU utilization and admission rates declined year over year following program implementation, with consistently lower utilization observed among prenatally engaged members. Program penetration increased over time, reaching 31% of the delivery population by Year 2. Post-implementation, the engaged cohort had higher maternal age and higher rates of mental health conditions and hypertension compared with the unengaged cohort. In the overall population, NICU days per 1,000 deliveries decreased by 35.6% from baseline to Year 2, declining from 1,687 to 1,086. Prenatally engaged members demonstrated consistently lower NICU days per 1,000 deliveries in both Year 1 and Year 2 (1,373 and 918, respectively). NICU admission rates decreased by 32.5%, declining from 12.3% at baseline to 10.1% in Year 1 and 8.3% in Year 2, with lower admission rates consistently observed among engaged members.
CONCLUSIONS: Participation in a multidisciplinary virtual maternity program is associated with large, longitudinal reductions in population-level NICU utilization. Lower utilization among engaged members was directionally consistent with broader population-level declines as program penetration increased, suggesting the program may contribute to reduced NICU utilization and associated healthcare costs.
METHODS: This retrospective cohort analysis included all deliveries (N=11,601) from a commercially insured population between September 2023 and November 2025. Claims-derived NICU days per 1,000 deliveries and NICU admission rates were compared across three periods: baseline year pre-implementation, Year 1, and Year 2 post-implementation. Outcomes for the overall population were compared with a cohort that engaged prenatally with the 24/7 virtual maternity clinical team. Two-proportion z-tests were used to assess differences in cohort comorbidities.
RESULTS: NICU utilization and admission rates declined year over year following program implementation, with consistently lower utilization observed among prenatally engaged members. Program penetration increased over time, reaching 31% of the delivery population by Year 2. Post-implementation, the engaged cohort had higher maternal age and higher rates of mental health conditions and hypertension compared with the unengaged cohort. In the overall population, NICU days per 1,000 deliveries decreased by 35.6% from baseline to Year 2, declining from 1,687 to 1,086. Prenatally engaged members demonstrated consistently lower NICU days per 1,000 deliveries in both Year 1 and Year 2 (1,373 and 918, respectively). NICU admission rates decreased by 32.5%, declining from 12.3% at baseline to 10.1% in Year 1 and 8.3% in Year 2, with lower admission rates consistently observed among engaged members.
CONCLUSIONS: Participation in a multidisciplinary virtual maternity program is associated with large, longitudinal reductions in population-level NICU utilization. Lower utilization among engaged members was directionally consistent with broader population-level declines as program penetration increased, suggesting the program may contribute to reduced NICU utilization and associated healthcare costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD69
Topic
Clinical Outcomes, Health Service Delivery & Process of Care
Disease
Pediatrics, Reproductive & Sexual Health