Consumer / Employer, Payers

HHS Launches New Medicaid Care Model To Improve Maternal Health Outcomes

HHS announced a new care model that aims to provide mothers with Medicaid coverage with more personalized maternal health care. This includes access to doulas and midwives and screening for health-related social needs.

The U.S. Department of Health and Human Services unveiled a new care model on Friday that aims to help state Medicaid agencies improve maternal health outcomes.

The 10-year payment and care-delivery model is called the Transforming Maternal Health (TMaH) Model. It will “support participating state Medicaid agencies (SMAs) in developing and implementing a whole-person approach to pregnancy, childbirth, and postpartum care for women with Medicaid and Children’s Health Insurance Program (CHIP) coverage,” HHS said. Specifically, it aims to reduce low-risk cesarean sections and maternal morbidity rates.

Participating state Medicaid agencies will be able to receive up to $17 million during the 10 years. The care model has three main pillars:

  • Improving access to care: State Medicaid agencies participating in the model will increase access to doulas, midwives and perinatal community health workers. These maternal health players have been shown to reduce cesarean sections, shorten labor time and lower rates of postpartum depression, according to CMS.
  • Quality improvement: State Medicaid agencies will work with hospitals and health systems to help them receive the CMS “Birthing-Friendly” designation, which is given to hospitals that have proven to provide high-quality maternity care.
  • Whole-person care: State Medicaid agencies will aim to make sure that mothers receive personalized care for their needs through a “unique birth plan” created in collaboration with the mother, CMS said. Expectant mothers will be screened during the first prenatal visit to understand if they require support for mental health, substance use disorder or social needs. State Medicaid agencies will also leverage remote monitoring for conditions like hypertension and diabetes.

“CMS is taking a comprehensive, evidence-based approach to achieve our goal of making tangible improvements in maternal health and birth outcomes,” said CMS Administrator Chiquita Brooks-LaSure in a statement. “The Transforming Maternal Health Model furthers our commitment to improve the experience for all pregnant women across the country, regardless of their background and ethnicity.”  

The launch of this care model comes at a time when maternal mortality has been on the rise in the U.S. In 2021, 1,205 women died of maternal causes in the U.S., versus 861 in 2020 and 754 in 2019, according to the Centers for Disease Control and Prevention.

“We have heard loud and clear that many women do not feel listened to or supported during their birth experience, and the current rate of maternal morbidity and mortality is deeply concerning,” said CMS Deputy Administrator and Innovation Center Director Liz Fowler in a statement. “This model aims to improve health outcomes for mothers and their newborns, and support a system that makes mothers feel empowered, safe, and healthy throughout their pregnancy and postpartum.”

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