Federal officials announced 14 states and Washington, DC will share $17 million to implement a new maternal health model.
A New Model of Care
Funding for the Transforming Maternal Health model is being provided to states via their Medicaid and Children’s Health Insurance Programs, often called the CHIP program. Most state Medicaid programs provide coverage to low-income pregnant women and young children, while CHIP can provide coverage for children through age 18.
Experts are seeking methods to improve outcomes while reducing health care costs – a tall order considering the U.S. spends more per capita on maternal health than any other country, yet still has a maternal mortality rate that’s more than double other high-income countries.
Laying the Foundation for Success
During the first three years of the model, called pre-implementation, states will receive technical support to establish access, infrastructure and workforce capacity.
Building a network of midwives, doulas and perinatal community health workers is one example. Broader access to these providers has been shown to reduce cesarian sections for low-risk pregnancies and shorten labor time, for example. And continuing the care relationship beyond birth can result in lower rates of postpartum anxiety and depression.
Implementing Patient-Centered Care
During the following seven years, states will execute their “whole-person approach to pregnancy, childbirth, and postpartum care.”
The goal is for each woman to have a customized care plan that addresses her physical and mental health, as well as any social needs she may have during pregnancy. This support could include a range of services from counseling for a substance use disorder to remote monitoring of hypertension.
Shifting to Value-Based Care
By the program’s fifth year, states are expected to transition from fee-for-service models, which are historically transactional, to value-based payment systems, which are more oriented toward encouraging wholistic approaches to improving patient outcomes. This shift aligns with CMS’ broader goals for health care delivery and encourages closer attention to patient-centric and culturally sensitive care.
Underserved populations facing higher risks of maternal complications will be prioritized, helping to close the gap between outcomes for these mothers and the broader average. The models will target these disparities in a step toward more equitable maternal care.
Policymakers and stakeholders alike will be keeping a close eye on implementation of this model and its transformative approach to addressing systemic gaps in maternal care.
