The Keystone Birth Collaborative is building a regional birth center network — partnering hospitals, FQHCs, surgical centers, and midwives to expand access across the Harrisburg–York–Carlisle corridor.
An RRM Foundation Initiative · South Central Pennsylvania
Pennsylvania's maternal health system is under mounting strain. For families in the South Central corridor, the consequences are measured in miles, minutes, and lives.
Pennsylvania's own Rural Health Transformation Plan identifies behavioral health conditions — including overdose and suicide — as the leading drivers of maternal mortality. The South Central corridor's rural edges — Perry County, parts of Adams and Franklin — face the most acute access gaps. This is the moment to build the infrastructure that prevents the next closure.
PA's Rural Health Transformation Plan creates Maternal Health Hubs as regional coordination centers. The Keystone Birth Collaborative is the South Central region's hub-and-spoke implementation.
Regional coordination center providing comprehensive care management and navigation from preconception through 12 months postpartum. Multi-disciplinary teams: nurse care managers, doulas, CHWs, peer recovery specialists, social workers, behavioral health coordinators. Centralized functions that individual practices can't sustain alone.
Midwifery-led, licensed freestanding birth center for low-risk pregnancies. PA's RHTP explicitly names "expanding birth centers as midwifery-led spokes" as a key strategy. Prenatal, intrapartum, and postpartum care with safe transfer protocols for higher-risk cases.
Higher-risk referral, C-sections, NICU, and 24/7 backup. Tele-MFM specialist connections. Joint simulation training. Potential for reopening closed L&D units where viable.
Primary entry point for prenatal and postpartum care. Embedded behavioral health screening. PA Navigate for closed-loop referrals. Social needs navigation across the network.
Gynecologic procedures freeing hospital capacity. Coordinated perioperative care across the network, enabling hospitals to focus acute resources where they matter most.
Cross-cutting across all sites. Perinatal TiPS (telephonic psychiatric consultation, <30 min response). Tele-behavioral health. Peer recovery specialists. Embedded screening at every point of contact.
Payment Model: Per-member-per-month (PMPM) funding initially, transitioning to value-based payment as outcomes improve — exactly as PA's Rural Health Transformation Plan envisions for Maternal Health Hubs.
The Keystone Birth Collaborative is the implementation of what Pennsylvania's Rural Health Transformation Plan already envisions. Here's how we align with each of the five CMS goals.
Directly addresses maternity care — the #1 stakeholder-identified priority across dozens of listening sessions. The midwifery model reduces reliance on costly hospital care while providing more years of healthy life.
Birth center as permanent local access point within the South Central RCC. Medicaid-reimbursable under 55 Pa. Code §1127. PA's goal: reduce pregnant women with inadequate prenatal care by 20%. PMPM funding transitions to value-based payment for long-term sustainability.
FM-OB fellowship pipeline (PA-specific program in RHTP). Training for midwives, doulas, CHWs, and peer recovery specialists. Five-year rural service commitments. PA's goal: 10% reduction in rural hospital vacancy rates plus 3 new training programs.
Hub coordinates, spokes deliver. Risk stratification and safe transfer protocols. Remote patient monitoring for hypertensive disorders. Perinatal TiPS telephonic psychiatric consults (<30 min response). Group prenatal care models.
Consumer-facing new mom app (PA has co-developed one). Tele-MFM into community settings. Shared EHR clinical integration. Remote monitoring devices transmitting daily readings to hub-based tele-RNs.
The Collaborative includes a training arm — interdisciplinary education across all partner sites, aligned with PA AHEC and the RHTP workforce strategy.
Shoulder dystocia, hemorrhage, neonatal resuscitation — joint hospital, FQHC, and midwife drills that build muscle memory and team cohesion across care settings.
Surgical obstetric fellowship for family medicine physicians (PA RHTP Attachment F). A 12-month program requiring 100+ deliveries and 50+ C-sections. 66.5% of FM residents trained in PA stay in-state.
Scopes of practice, team-based workflows, and collaborative care models. Joint education on safe transfer protocols ensures seamless handoffs between birth center, hospital, and FQHC teams.
Monthly morbidity and near-miss case rounds. PA Perinatal Quality Collaborative participation. Data-driven quality improvement that raises the bar for every partner site.
Community member → doula → CHW → peer recovery specialist → midwife or nurse. Scholarships, mentoring, short-term housing, and stipends with five-year rural service commitments.
PA's goal is 25% of births in hub regions engaged with the hub. Shared metrics drive accountability and continuous improvement across the network.
Every outcome metric comes directly from Pennsylvania's Rural Health Transformation Plan. This isn't aspiration — it's accountability.
More local entry points. Reduced travel. PA Navigate for closed-loop referrals connecting families to community resources, WIC, housing, and social services.
The midwifery model delivers higher breastfeeding rates and lower intervention for appropriate patients. Integrated behavioral health addresses the leading driver of maternal mortality.
Approximately 16% cost reduction per birth center birth versus hospital delivery. PMPM funding transitions to value-based payment, creating long-term financial sustainability.
Shared protocols, joint training, coordinated transfers. Regional efficiencies from shared monitoring infrastructure reduce duplication and lift every partner.
PA's Rural Health Transformation Plan is heavily tech-focused. The Collaborative builds the digital backbone that connects every partner site and every patient.
Blood pressure tracking devices for hypertensive disorders. Daily readings transmitted to hub-based tele-RNs. Abnormal results trigger immediate intervention and tele-MFM consults.
Hub-and-spoke telehealth access points. Tele-MFM, tele-behavioral health, and peer-to-peer consultation. The Perinatal TiPS line provides rapid psychiatric support in under 30 minutes.
PA has co-developed a new mom app with PA-specific resources. The Collaborative integrates it as a patient engagement and education layer — connecting mothers to local providers, community resources, and telehealth.
Clinical integration of electronic health records across all partners. Shared quality dashboards. PA Navigate for closed-loop referrals that follow patients across every care setting.
The Harrisburg–York–Carlisle corridor and its surrounding rural counties form the South Central PREP region — eight counties where birth care access is most needed.
The Keystone Birth Collaborative is a regional partnership initiative bringing together hospitals, federally qualified health centers, surgical centers, midwives, and community organizations to build an integrated birth care network in South Central Pennsylvania.
We exist because no single institution can close Central PA's birth care gap alone. The Collaborative provides the coordination layer — the shared protocols, joint training, quality infrastructure, and care navigation — that transforms independent providers into a connected system.
The Keystone Birth Collaborative is an initiative of the RRM Foundation, a 501(c)(3) nonprofit organization (EIN: 93-4594315) dedicated to advancing reproductive and restorative medicine research, education, and clinical access. RRM Foundation provides the organizational backbone, fiscal sponsorship, and strategic direction for the Collaborative.
Partner logos will appear here as organizations join the Collaborative.
Central PA's birth care future depends on partnerships. Whether you lead a health system, run an FQHC, or practice midwifery, there's a role for you in this network.
Partner with us to expand maternal care access in your region. The hub model strengthens your referral network, provides workforce training, and positions your institution as a leader in PA's Rural Health Transformation.
Contact Us →Integrate birth care into your existing services. The Collaborative provides the coordination, training, and behavioral health integration that community health centers need to serve pregnant and postpartum patients effectively.
Contact Us →Practice in a supported, team-based network. The birth center spoke offers midwives a collaborative environment with hospital backup, shared training, and the infrastructure to focus on what matters — care.
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