Centering Healthcare Institute

At a Glance

National Office: 
89 South Street Suite 404
Boston, MA 02111
Phone: 857-284-7570

Angie Trusedale
People Served: 
50,000
Year Founded: 
2001
Tax ID: 
06-1622668

Focus area(s):

Maternal & Child Health

Description

Centering is an innovative, evidence-based model of group care that is effectively addressing the complex social determinants of health. This paradigm shift is making an impact by bringing patients out of the exam room and into a comfortable group setting. Patients receive the highest quality of care and, as part of an ongoing group, form a supportive community where they develop skills and confidence to take control of their health. The Centering model combines health assessment, interactive learning and community building to deliver better health outcomes and a better care experience for patients and their providers. Centering group care is currently in 425 practices throughout the US serving 50,000 women in 2015.

CenteringPregnancy® brings 8-12 women who are due around the same time together for prenatal care. Each of the 10 visits is 90 minutes to two hours long, giving women ten times as much time with their provider team than individual visits would allow. During the visit, the women engage in their care by taking their weight and blood pressure, record their own health data, and have private time with their provider for a belly check. The remainder of time is a facilitated discussion on health topics related to their pregnancy. The women learn from their provider and also from one another. This group time connects them to each other, creates support, and fosters their strengths.

CenteringParenting® provides family centered well-child care for the first two years, continuing on from CenteringPregnancy or starting when 6-8 parents and infants of the same age are brought together for care. In each two-hour visit, parents have a one-on-one assessment with the provider and then time for group discussion. Parents are actively involved in their child’s assessment at every visit: tracking their growth, development, immunizations and oral health. Individual well-child health assessments, immunizations and developmental screenings follow the Bright Future™ nationally recognized guidelines. An emphasis on family, self-care, wellness, and women’s health is woven throughout. Our data show, for example, that the children are breastfed for longer and get inoculations on time. Overall, the parents feel more secure as they gain medical understanding of their child’s development, and more supported as they take the child-raising journey with other parents.

Impact and Outcomes

Centering pregnancies last 2 weeks longer and babies are one pound heavier than traditional care.
33% reduction of preterm births, 41% in African American populations.50% reduction of preterm birth (Texas clinics).
50% of Centering mothers are less likely to have rapid repeat pregnancies, more likely to initiate breastfeeding, have significantly better prenatal knowledge.
96% patient satisfaction rate.
A Kentucky county government saved $1.5 million in medical costs by using Centering.

Mission & Goals

CHI is transforming healthcare through Centering groups. The following goals are outlined in our five-year strategic plan.

·         CenteringPregnancy nationally recognized as the optimal prenatal care approach

·         CenteringPregnancy growth is accelerated through large market scale and spread

·         CenteringParenting proven as a viable model of family oriented well-child care

·         Establish an infrastructure for the measured growth of Centering internationally

·         Explore applying the Centering model to chronic disease populations such as diabetes

Program

CHI’s work involves several goals for both individuals and the healthcare system. On a personal level, CenteringPregnancy advances better outcomes for pregnant women and their babies, i.e., fewer preterm births and low birth weight infants, and greater knowledge, smoother pregnancy, and increased support for the moms. CenteringParenting helps ensure that children get off to the best possible start through breastfeeding, innoculations, safety, and appropriate family planning.

On a broader scale, CHI seeks nothing less than transformation of the healthcare system from individual to group care. This includes the scale and spead of Centering as a viable and provably effective model, and working with the insurance system to ensure appropriate reimbursement for group sessions as they would for individual sessions.

We accomplish all of these goals by creating, promoting, and continuously improving the CenteringPregnancy and CenteringParenting models of group healthcare, which bundle health assessment, interactive learning, and community building. Centering is defined by Essential Elements that provide the foundation for start up and sustainability over time. There is flexibility within the framework so that practice sites may adapt to the special needs of their populations or setting.

Centering is suitable for any population or care setting. Women in Centering groups have varied backgrounds: low literacy and college graduates, rural and urban, US born and immigrants. Centering is found in community health and public health centers, Federally Qualified Health Centers (FQHC), teaching hospitals and clinics, and private practice.

To further the goal of increasing the use of group healthcare, we partner with clinical practice sites and guide them through the process of change. Our comprehensive Centering Implementation Plan engages all levels of the organization so that everyone – CEOs, doctors, nurses, administrators, and facilitators – all understand and enthusiastically embrace the model. We pair each practice site with a Centering consultant who works with the staff, and we provide resources, training, and materials that enable clinical sites to enact group care in a way that best suits their medical and social environment.

Central to our mission is supporting research that demonstrates the power of group healthcare. Internally, our site approval process ensures the fidelity, consistency, and sustainability of the Centering model. This quality assurance effort uses our CenteringCounts data system to capture information on recruitment and retention, patient satisfaction, health outcomes, and key performance measures of the organization that support the model. Our data show that Centering achieves the nationally recognized Triple Aim of better care, better health, and lower cost in healthcare delivery. This data and other information gathered independently support ongoing evaluation of outcomes.

Impact

The evidence is clear: CenteringPregnancy dramatically reduces the rate of preterm and low birth weight babies, which saves millions of dollars in lifelong healthcare costs and years of parental anguish. CHI partners with researchers to explore the benefits of Centering group care and their studies demonstrate its power. In a 2007 randomized controlled trial, 9.8% of women assigned to group prenatal care had a preterm birth compared with 13.8% in individual prenatal care, a 33% risk-reduction. A 2012 retrospective analysis reported 47% reduction in preterm birth among women in group prenatal care compared with those in traditional care. In both of these studies, disparities in preterm birth rates between white and black mothers were also significantly reduced (view the full studies at the links on the left and please go herefor a full bibliography of articles and research).

 

On an individual level, Centering group care makes a strong impression on both patients and providers. Expectant mother often give us feedback like, “I get more attention and get more out of the group than a one-on-one” and “We started on time and ended on time and something happened the whole time we were there.” Providers are also more satisfied with the care they are able to give through Centering. As one described it, “[With CenteringPregnancy] it feels like we’re able to provide a much richer quality of care to the patients. Sometimes I feel like when I go back to giving my regular care to the other patients, it’s like, oh, it’s not fair, you’re not getting as much as the other ones are.”

Growth Plan

A three year growth plan from 2011-2013 focused on establishing infrastructure, the growth of Centering sites, and demonstrating quality of Centering sites through site approval. In 2013, we wrote a five-year strategic plan. The first objective is to demonstrate how CenteringPregnancy achieves the Institute for Healthcare Improvement’s Triple Aims of better care, betterhealth, and lower cost. Objective 2 is the scale and spread of approved CenteringPregnancy sites, including membership renewal by 90% of sites. Another major goal is to accelerate our growth by establishing Centering in large hospital systems, so that all or most practices affiliated with those systems use the Centering model of group healthcare. Over the next few years, we are also developing and rolling out systems to collect data from all Centering sites, and creating more robust data and site evaluation systems. We are also actively enhancing our marketing and product development, and increasing our policy and advocacy work, i.e., working toward enhanced reimbursement from payers to Centering sites. To support all of this, we are building our organizational capacity, including technology and financial sustainability. 

Location of Sites

National Office: 
89 South Street Suite 404
Boston, MA 02111
Phone: 857-284-7570
List of locations

To make a contribution to a program site:

  1. Click on the "Make a Contribution Now" button and include the name, city and state of the program you would like to support, in the "notes" text box on the organization's donation form, if available.
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Locations in the following states:

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Financials

Most Recent Budget

Year Ended:

2016

REVENUE

Corporate Grants: 
$0
Foundation Grants: 
$407,860
Government Funding: 
$0
Contributions from Individuals: 
$0
Special Events: 
$1,426,000
Program Services Fees: 
$904,763
Membership Dues: 
$1,095,067
Other Earned Income: 
$130,305
Other Revenue: 
$3,800
Total Revenue: 
$3,967,795

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$1,889,809
Occupancy: 
$673,470
Travel & Entertainment: 
$116,116
Office Supplies, Printing, Postage: 
$216,597
Telephone & Communications: 
$60,919
Payments to Affiliates: 
$815,539
Other Expenses: 
$2,000
Other Expenses (Description): 

Staff & Faculty Development, Insurance, Bank Charges, Other

Other Expenses (Description): 

Other Expenses (Description): 

Other Expenses (Description): 

Total Expenses: 
$3,774,450

NET GAIN/LOSS

Net Gain/Loss: 
$193,345

Prior Year Actuals

Year Ended:

2015

REVENUE

Corporate Grants: 
$92,014
Foundation Grants: 
$225,846
Government Funding: 
$0
Contributions from Individuals: 
$3,126
Program Services Fees: 
$641,834
Membership Dues: 
$102,761
Other Earned Income: 
$933,529
Other Revenue: 
$24,007
Other Revenue (Description): 
Interest and misc.
Special Events: 
$1,039,069
Total Revenue: 
$3,062,186

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$1,393,378
Occupancy: 
$452,429
Travel & Entertainment: 
$52,047
Office Supplies, Printing, Postage: 
$93,905
Telephone & Communication: 
$64,895
Payments to Affiliates: 
$729,024
Other Expenses: 
$11,417
Other Expenses (Description): 

Insurance and others

Total Expenses: 
$2,797,095

NET GAIN/LOSS

Net Gain / Loss: 
$265,091

Major Funders

Kellogg

AmeriGroup

Strategic Grant Partners

March of Dimes

Blue Cross Blue Shield Foundation

CMMI

United Way Georgia

Kaiser Foundation Georgia

Anthem