BEAM Collaboration Takes First Steps to Improve Birth Equity

December 28, 2023 · Andy Reynolds

NCQA and our colleagues at Reproductive Health Impact (RH Impact) have finished the first part of our three-phase collaboration to help align all levels of the health care system toward birth equity.

Findings and recommendations presented in a December 2023 webinar and accompanying reports show our organizations’ joint effort—the Birth Equity Accountability through Measurement (BEAM) initiative—is making progress to improve birth equity.

BEAM’s Why and How

As we’ve written recently, BEAM aims to disrupt the birth equity status quo—an area of inconsistent quality plagued by:

• Persistent mortality gaps among non-Hispanic Black birthing people.
• Increasing mortality rates across multiple groups.
• Quality measures that lack an equity lens.

The BEAM initiative will create, test and implement a quality measurement approach that makes being pregnant and giving birth safer—especially for people from historically marginalized communities.

The initiative aims to:

• Drive equitable care.
• Address racist practices and policies.
• Promote joint accountability across all entities.
• Center patient voices, especially the voices of Black birthing people.

PHASE 1

The BEAM team has completed the first of three planned phases.

Phase 1’s culminating webinar revealed the new Birth Equity Measurement Framework that the collaboration has produced.

That framework is designed to:

• Guide quality measure development.
• Stimulate systems-level dialogue about accountability.
• Inform how the health care system might envision strategies to promote birth equity.

PHASE 2

In the project’s second phase, BEAM colleagues will develop measures and establish the feasibility of the framework.

The team will:

• Develop prioritized measures that can improve birth equity across the delivery system.
• Convene a learning network to test equity-focused perinatal quality measures across the health care system.

PHASE 3

In the collaboration’s third phase, the BEAM team will inform national evaluation programs for quality improvement and accountability.

NCQA and RH Impact collaborators will:

• Develop a toolkit to help organizations apply BEAM findings and insight.
• Promote and implement measure bundles into national accountability programs.
• Disseminate bundles and a “change package” outlining how to use the measures to improve birth equity.

Meet the BEAM Wheel of Accountability

The Birth Equity Measurement Framework comes to life in a multi-dimensional and interactive wheel.

The wheel is inspired by the pregnancy wheel that calculates a due date based on the first day of the birthing person’s last menstrual period.

Its design centers the birthing person with rotating layers of stages of care, birth equity factors and accountable entities. When you turn each layer, the wheel can produce 27 combinations of areas to be addressed.

The wheel pushes the concept of birth equity beyond linear thinking. Stakeholders can consider the 27 combinations that the wheel’s layers can support. The framework can also foster conversations about accountability across the wheel’s layers.

The framework acknowledges the roles of racism, discrimination, and social drivers of health as birth equity factors. These factors interfere with and overlay how birthing people receive care and interact with the health care system.

In another layer, the framework addresses joint accountability across:

• State governments.
• Payers and health plans.
• Service providers, including hospitals, birthing centers, clinicians, allied birth workers and community organizations.

In Phase 3, stakeholders will be able to interact with the wheel to create and explore the 27 iterations.

Go Deeper

To learn more about BEAM:

• Visit the BEAM webpage.
• Watch the December 2023 webinar.
• Consult our blog for context and history about the quality case for birth equity.