Starting in 2027, a shift in how maternity care gets billed could mean either better postpartum support or bigger bills for families — here’s what’s at stake, and why we’re launching RISE now.
What’s changing and why
In January 2027, the way maternity care gets billed is changing. Currently, obstetric providers receive a single “bundled” payment covering all maternity care services they’ve provided. In its place is a new “unbundled” payment system billing for individual, itemized evaluations. This approach is based on patients’ needs or risk of complications, yet patient advocates question whether these changes will lead to better care outcomes or increased patient costs.
OB-GYNs and providers who support the new payment model say the currently bundled approach does not accurately reflect the realities of modern maternity care. Pregnant patients are increasingly requiring management of chronic conditions such as hypertension, diabetes, and mental health disorders; however, providers receive the same payment regardless of care complexity. The new billing system is expected to improve transparency, better align care services, and accommodate more complex medical needs.
The upside: better postpartum follow-up, the risk: who pays for it
This approach creates room to reimagine maternity care by building a comprehensive team of maternity care practitioners to strengthen postpartum care. [Source] Historically, maternity payment has focused on a single postpartum visit within six weeks of delivery, despite maternal health complications that often emerge after that window. Advocates hope this new payment structure will support a more comprehensive and inclusive follow-up, including mental health screenings, lactation support, and care coordination.
This shift also raises concerns about affordability and rising costs, especially for commercially covered patients. Many prenatal services are included in one global claim under the current bundled payment system. Unbundled, patients could receive separate claims for individual visits and services, potentially increasing out-of-pocket medical expenses, depending on their health insurance plan. Preventive prenatal care is generally charged at no cost to members under federal law, yet insurers haven’t said how they’ll classify or cover maternity services under the new system. [Source] It also brings new administrative burdens, especially for smaller, independent, or rural health providers.
The discussions on how the payment system will unfold are still in their early stages, with several months remaining before the new year. But what’s important is this: Unbundling maternity care should be more than a billing change. Implemented with patients’ needs at the center, this model could support individualized, high-quality care for families through pregnancy and, importantly, the postpartum period. This change is an opportunity to ensure mothers and birthing people feel supported and see better clinical outcomes throughout the entire perinatal period, not just in a short postpartum window.
Why RISE matters
We believe the world will be a better place if we reimagined postpartum as a time of care, connection, and collective support. And we believe in the power of financial stability during pregnancy and postpartum. As we continue to engage in advocacy, our direct service programming is meeting the need. That’s why we are launching RISE – Resources for Income, Shelter, and Empowerment – our new pilot program centering unrestricted cash assistance for low-income mothers in LA County to provide full wraparound postpartum support.
This fall, we plan to offer $250,000 in direct cash for single mothers and birth parents to help meet their needs, whether for rent, groceries, child care, or transportation, with full autonomy in their decisions.
Financial support during the postpartum period is crucial, and your support makes it a reality. Donate today, or contact Eboni Nash (eboni@4thtri.org) to sponsor RISE or explore a partnership.
