Why Virtual OB Care Is Essential in the Era of Maternity Care Unbundling
For decades, maternity care was organized around a single structure: a 12-to-14-visit schedule that has been the default since the 1930s, paired with a reimbursement model that assumed one practitioner was the entire care team across pregnancy and postpartum.
Over the past two years, two changes to that outdated system have begun reshaping how prenatal and postpartum care gets delivered. On the clinical side, ACOG's May 2025 clinical guidance, Tailored Prenatal Care Delivery for Pregnant Individuals, moved the field away from the standard schedule toward individualized care for average- and low-risk patients, with fewer in-person visits supported by complementary telemedicine. On the payment side, beginning January 1, 2027, the global obstetric package retires, and maternity care will be reported as separate antepartum, labor, delivery, and postpartum services; better reflecting the distinct care delivery provided in each phase.
These updates enable the same critically needed recalibration, and they both point at the same truth: pregnancy has never been a single episode of care, and our care models now have the guideline-backed infrastructure to catch up to what high-quality, value-driven perinatal care truly requires.
That same recalibration, though, is also where risks live. Tailoring visits and unbundling payment both add touchpoints and documentation while, for low-risk patients, reducing in-person visits. Done well, that's better, more patient-centered care. Done without a plan, it’s how patients can slip through: the rising-risk patient whose pressures drift between appointments, the postpartum patient who misses their one visit, the feeding problem that escalates because no one was watching.
ACOG was explicit about both the upsides and the conditions. Reducing appointments for average-risk patients is meant to improve availability for patients with more complex needs, but only if reliable clinical access holds the space between visits.
That's where we come in.
SimpliFed is a virtual care layer that sits inside your practice, not beside it. We help your practice run a tailored care model safely:
- For low-risk patients, we provide the virtual touchpoints, education, feeding support, structured check-ins, to let a reduced in-person schedule stay supported.
- For higher-risk patients, we can facilitate between-visit check-ins and timely communication to surface rising risk back to your team before the next scheduled appointment.
- When a patient misses an in-person visit, we can reach in to assess, re-engage, and coordinate them back into your care rather than letting the gap compound.
- Across the board, we carry the feeding and lactation load, delivered by board-certified lactation consultants, with optional visit summaries back to you.
Here's what this looks like in practice. A patient three weeks postpartum books a virtual visit because feeding hurts and she's convinced she's failing at it. Our clinician works through the latch and the feeding plan, and in the same visit notices what a feeding-only encounter would miss: the flat affect, the tearfulness, the quiet "I just can't do this." A brief validated screen confirms it. Her postpartum OB visit is still three weeks out. Rather than wait, we flag it to her care team that day and move her toward mental health support right away, inside the early window when intervention matters most. The feeding question was the door; catching the depression behind it is the care.
Virtual care is well positioned to complement in-person care, adding a layer of follow-up and rising-risk alert. ACOG's own logic is that redistributing low-risk volume protects practice capacity and time for complex patients, and virtual care is the infrastructure that makes that redistribution responsible, facilitating more eyes and more access points between visits, while coordinating closely with the patient's practice.
Unbundling raises the stakes on continuity of care. When each phase of the patient's journey, and its inherent complexity, is documented on its own, the gaps between phases, representing the opportunities for preventive support, become visible, both clinically and financially. A virtual layer that keeps patients engaged across antepartum, postpartum, and infant feeding is how a practice protects both outcomes and the integrity of the care it's accountable for.
And the equity piece is a lived reality: patients perceived as lower-acuity, and those who are lower-resourced, are the ones most likely to be left behind as care becomes more itemized. Accessible virtual support reaches them earlier and creates a direct point of clinical access, before a manageable issue becomes an urgent or emergent one.
The shift coming to maternal health care in 2027 is bigger than a coding change. It's a structural rethink of what pregnancy care is, and it rewards practices that build for continuity to improve access and outcomes. At SimpliFed, we are building for exactly this. If your practice is mapping out how to deliver tailored prenatal care and navigate unbundling without losing sight of patients between visits, we'd love to hold that space with you.
Melissa Walsh, MD, FACOG
Medical Director @ SimpliFed
Ref:
New ACOG Guidance Recommends Transformation to U.S. Prenatal Care Delivery
Payment for Obstetric Services | ACOG, Payment for Obstetric Services – Coding / AMA 2027 restructure — the Jan 1, 2027 unbundling
