14 states to participate in maternal health model
The model is designed to focus exclusively on improving maternal healthcare for people enrolled in Medicaid and CHIP.
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The Centers for Medicare and Medicaid Services kicked off its Transforming Mental Health (TMaH) Model at the beginning of the year, and this week announced the 14 states that will be participating in the 10-year model.
The model is designed to focus exclusively on improving maternal healthcare for people enrolled in Medicaid and Children's Health Insurance Program (CHIP). It will support participating state Medicaid agencies (SMAs) in the development of a whole-person approach to pregnancy, childbirth and postpartum care and address needs such as physical and mental health.
CMS said the model's goal is to reduce disparities in access and treatment, and to improve outcomes while also reducing overall program expenditures.
The 14 states participating in the model are Alabama, Arkansas, California, Washington, D.C., Illinois, Kansas, Louisiana, Maine, Minnesota, Mississippi, New Jersey, Oklahoma, South Carolina, West Virginia and Wisconsin.
WHAT'S THE IMPACT?
According to CMS, the U.S. has disproportionately high rates of adverse pregnancy outcomes when compared to other high-income countries, despite spending more per capita on maternal healthcare.
What the TMaH Model does is provide SMAs with targeted support in the form of funding and technical assistance, with the goal of improving outcomes and reducing disparities. It also enables states to develop a value-based alternative payment model for maternity care services, said CMS, which is expected to promote the long-term sustainability of services.
The model's initiatives will center on three main pillars: access to care, infrastructure and workforce capacity; quality improvement and safety; and whole-person care delivery. Participating SMAs will implement quality initiatives and protocols with a goal of making childbirth safer, while individuals will be screened during their initial prenatal visit to determine what, if any, additional support they may need for health-related social needs, mental health or substance use disorder. Based on their physical, social and mental health needs, a care plan will be developed in collaboration with the mother.
People may also be connected with community organizations or a community health worker depending on the health-related social needs they may have.
All participating state Medicaid agencies will develop and implement a health equity plan that addresses disparities among underserved populations. Participating state Medicaid agencies will also support the extension of Medicaid and CHIP postpartum coverage to 12 months to promote preventive care, overall health, and reduction of care costs.
THE LARGER TREND
Understanding the disparities faced by various racial and ethnic groups is key to addressing preterm births and low birth rates, which should spur action from payers, providers and lawmakers, a 2023 Health Affairs study found.
Specifically, the authors said that state and local lawmakers wield considerable influence in reducing disparities in maternal health outcomes, since many originate from historically inequitable local policies.
Maternal care deserts are a known and increasing problem. Between 2020 and 2022 there's been a 5% increase in counties in the United States that have less maternity access, according to a March of Dimes report. There's a 2% increase in counties that are considered maternity care deserts.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
