Quilted Health was founded in 2019 with the vision to build an equitable, accessible, and sustainable model of pregnancy care for all people. We did this with an eye towards what has become known as “value-based care” across the healthcare industry. In the simplest terms, that means we wanted to increase access to high-quality and community centered care while redesigning the business model around it. We believed that if we could demonstrate how value-based care creates immediate and long-term outcomes that are both superior and cost less, our current healthcare system would be willing to invest more in that model over time. Around this time, much of the country was also waking up to the reality that our maternal health outcomes are amongst the worst of developed nations, and especially so for BIPOC and marginalized populations. People were also realizing what midwives have known all along—one of the most impactful and certain ways to achieve better outcomes and lower costs overall is to have more people’s care in the skilled hands of midwives. We knew it would take years, if not decades, to demonstrate the success of this model, and we moved forward with the support of investors, payers, and other partners who were excited to take that journey with us.
From 2020 – 2022, amidst the COVID-19 crisis, we set out to prove the naysayers wrong—YES, people do want midwifery care; they may just not know it’s an option for them, or there may not be such an option in their community. YES, midwives can independently care for a very broad range of clinical scenarios, and when supported with trusting physician relationships, will deliver outcomes on par with or exceeding global benchmarks. YES, these outcomes will lower costs, not by underpaying or undervaluing our providers, but by reducing unnecessary interventions that cost a lot of money. We could then compensate providers for the value they create and continue to invest in the growth and sustainability of midwifery overall.
We were so excited—organizations across the country were eager to partner, and our early teammates and midwives recruited prior colleagues and friends to join in the hopeful possibility of this future. We were intentional about hiring a diverse team because we knew that people who received care from providers of similar background and lived experiences have better outcomes. We accelerated our efforts to engage people early in pregnancy and educate them about midwifery options for care. We opened two clinics from scratch and then opened a third location with a well-established midwifery group in Spokane, Washington. We partnered with payers to “launch” into new states outside of our home state of Washington, with the intention that our partnership and long-term view could wait for the missing elements of licensure, recognition, and reimbursement to catch up.
Through these years, every challenge or misstep became an opportunity for us to reflect and adjust how we achieved our goals. As we grew our own service offerings, we learned we could do more to bring solutions to the midwives already delivering care in the community to ease the administrative burden associated with care. As we navigated conversations with payers in an attempt to raise reimbursement to sustainable levels, we learned we could do more to bring other midwives along in that journey. We also learned that an abundance of dollars, digital advertising, or other awareness tactics will never be more effective than the intentional, lasting, steady presence that so many midwives have worked to build over the years. With those insights, we began to add additional offerings across technology, data, and practice support to help extend our resources to other midwives.
In 2023, an abrupt change in the investment and financial landscape forced us to face a harsh reality—the partnerships and investors we counted on to support us in the long term were suddenly less excited about investing in transformation that takes a long time. The measures of success were no longer focused on long term potential to change health outcomes, but rather the immediate financial sustainability and potential for return on investment. If we wanted Quilted to be around in the future, we had to focus on the one or two priorities that best supported our mission and long-term sustainability. As a result, we made the difficult decision to close two locations and pause expansion beyond the Pacific Northwest. This shift allowed us to concentrate our resources on strengthening existing midwifery practices and supporting the profession as a whole.
To many, these changes were sudden, unexpected, and not fully transparent as to ‘why’ in the moment. While I believe those twists and turns led us to a better place, I am sorry for how that moment impacted people and made them feel—especially the marginalized communities we set out to support.
