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The Business Case for Breastfeeding

team-based lactation care Jan 24, 2023
business case for breastfeeding primary care lactation

Making the business case for breastfeeding and team-based breastfeeding support is critical. 

When trying to garner administrative support for team-based breastfeeding care, financial questions often delay progress. Given the pressure in health care on time, efficiency, and volume, breastfeeding support can often be seen by practice administrators as a low-priority, time-intensive project that will not be cost sustainable. 

Breastfeeding saves lives and is cost-effective

In the Lancet breastfeeding series, the authors found that breastfeeding could save over 800,000 lives and $302 billion dollars. They also found it could cut the treatment of childhood illness and could save the US health care systems $2.45 billion annually. The health benefits of breastfeeding are evident for both parent and child. Breastfeeding also supports the value-based care model of medicine which models providing the highest quality care at the lowest possible cost. 

Improved outcomes for both parent and infant

The Academy of Breastfeeding Medicine Protocol: the Breastfeeding Friendly Physician Office notes that  “practices that employ a healthcare professional trained in lactation have significantly higher breastfeeding initiation and maintenance rates with mothers experiencing fewer problems related to breastfeeding.”

The US Preventive Task Force summary of primary care interventions that support breastfeeding identifies that breastfeeding improves health outcomes for both parent and infant.  They summarize that primary care breastfeeding support that provides “direct assistance, support, and education to mothers and families about breastfeeding” pre- and post-natally significantly increased rates of exclusive breastfeeding 

Individualize to your practice setting: create a business plan

The reality is health care is a business in the United States. When advocating for team-based LC/PCP care at a Federally Qualified Health Center (FQHC), we performed a financial analysis and created a business proposal. Using practice newborn volume, average insurance reimbursement for medical provider visits, and breastfeeding initiation “we estimated there would be approximately 400 additional lactation-related visits per year that would cover practice overhead and staff training while providing increased revenue to the practice.” 

Awareness of the need to cover costs allows you to speak administrators’ language. The analysis for the FQHC showed the patient volume was present to cover the cost of training a RN as a lactation consultant. This analysis can help determine if a gradual approach for implementation is more feasible versus hiring additional staff. Also, if your practice already has an LC, but the practice is not billing, this may be a chance to highlight the opportunity for reimbursement and financial sustainability. Showing that your program can cover the costs of changes helps justify the momentum and prioritize change. 

Team-based care: time-efficient, cost-effective, and improves outcome

The American Academy of Family Physicians and American Academy of Pediatricians recommend breastfeeding counseling should be part of routine pediatric preventive care. Yet, primary care providers (PCP) are limited by training and time during routine visits to provide all recommended counseling. Some health care systems want the health care provider to generate revenue and see 4 to 6 patients per hour.  Breastfeeding support requires longer visits. Advocating for team-based visits enables a health care provider working within that system to support breastfeeding and allow the more time-intensive support to be provided by the lactation consultant. Freeing up physician time for other physician specific activities helps with efficiency and cost.

What’s your core mission?

For most primary care practices, the core mission includes providing preventive medicine and primary care support to optimize the health of their patients. Early breastfeeding support is critical to this mission. Speaking to the core mission can also be a business argument, as it shows an investment in practice priorities. 

Patients value the services

When we interviewed patients about their experiences with team-based LC/PCP support we found they valued the service and found it helpful.  Patients stated they  “Loved the lactation support’’ and described it as  ‘‘Really excellent support.’’ Both primiparous and multiparous parents found it helpful. Specific examples of the benefits patients experienced included: ‘‘Helped make the process more calm’’ and ‘‘Helped a lot with positioning.’’ Administrators respond to what interests patients, as businesses want to serve their clients’ needs. We can help draw attention to these needs and refocus the priority.

Integrated care

Breastfeeding support is one area to work to provide high quality, time efficient collaborative care. Interested in learning more about team-based care? The Institute for Health Care Improvement has resources. Check out their blog moving ideas into action. 

Team-based LC/PCP care has the potential to transform primary care practices. Looking for a different approach to help your practice move ideas into action? Explore the business case for breastfeeding.

~Ann M. Witt, MD, FABM, IBCLC 

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