• Adequacy of prenatal care is based on the Kessner Index, which measures adequacy by the month the care began, number of prenatal visits, and length of the pregnancy. Prenatal care is adequate when it begins in the first trimester and includes, on average, at least one or two additional prenatal care visits per month, depending on the length of gestation. 
• This indicator is a three-year average percent of live births with less than adequate prenatal care. 

Adequacy, when defined as the number of prenatal appointments, is really an insufficient as a proxy for infant vitality when we consider all of the equity-based principles that impact the quality of care received. 

Nationally, a primary strategy for assessing respectful care is currently underway. We recently learned that the American College of Obstetrics and Gynecology (ACOG) will be focusing on this in their annual meeting later this year. For now, our health system uses the following metric as a proxy indicator assessing respectful care: % of patients reporting their provider treated them with respect

Policy Priority to Watch: 

Implement universal screening and referral and service system

• Fund localized community information exchange (CIE)

CIE is an ecosystem comprised of multidisciplinary network partners that use a shared language, a resource database, and an integrated technology platform to deliver enhanced community care planning. Care planning tools enable partners to integrate data from multiple sources and make bi-directional referrals to create a shared longitudinal record. By focusing on these core components, a CIE enables communities to shift away from a reactive approach to providing care toward proactive, holistic, person-centered care.