Medicaid insurers 'missing opportunities' to improve maternal care
The data found several gaps in how hospitals reported key maternal health metrics, impeding efforts to assess care quality.
Photo: juanma hache/Getty Images
States could do more to require Medicaid managed care organizations (MCOs) to improve access for maternal health, with a new Office of Inspector General report finding discrepancies in how hospitals report maternal health data – which in turn raises questions about the reliability of Medicaid data and the broader impact on maternal healthcare outcomes.
The report reviewed hospital data submissions from Medicaid providers across multiple states, finding several gaps in how hospitals reported key maternal health metrics, such as pregnancy complications, delivery methods and postpartum care.
These gaps, OIG said, could impede efforts to accurately assess the quality of maternal healthcare provided to Medicaid beneficiaries, particularly those from vulnerable and underserved populations.
Also highlighted was the inconsistent use of maternal health quality measures across states. Some states failed to collect sufficient data on essential metrics like cesarean section rates, preeclampsia and other high-risk-pregnancy indicators. The lack of standardization in data reporting not only complicates state-level oversight, OIG said, but also impacts federal efforts to address disparities in maternal health outcomes.
WHAT'S THE IMPACT?
The gaps in data reporting come at a critical time, as Medicaid is increasingly being recognized as a key player in addressing the nation's maternal health crisis. According to the OIG report, the inconsistencies in maternal health data make it difficult for policymakers and healthcare providers to fully understand the scope of maternal health issues within the Medicaid population.
This is particularly concerning given that Black and Native American women are more likely to experience maternal mortality and severe maternal morbidity compared to their white counterparts.
OIG underscored the need for improved data collection processes to support Medicaid's role in improving maternal health outcomes. Accurate and comprehensive data is essential for identifying high-risk pregnancies, assessing healthcare quality and ensuring that Medicaid beneficiaries receive appropriate maternal and postpartum care, the report said.
The Centers for Medicare and Medicaid Services has taken several steps to address the maternal health crisis, including expanding postpartum coverage and implementing quality improvement initiatives. But the report suggests that further action is needed to ensure these initiatives are supported by accurate data collection and reporting mechanisms.
In response to the report, CMS has acknowledged the need to improve the consistency of maternal health data across states and has committed to working with state Medicaid agencies to implement more standardized reporting practices. CMS has also highlighted ongoing efforts to improve maternal health outcomes through initiatives such as the Maternal Health and Quality Improvement Learning Collaborative.
The collaborative aims to enhance maternal health services through better data sharing and the use of evidence-based practices. However, without accurate data to guide these efforts, it remains difficult to fully assess the success of these programs and their impact on reducing maternal mortality and morbidity rates, OIG said.
THE LARGER TREND
A Health Affairs analysis from last year suggested Medicaid expansion appears to be a boon to the Biden administration's push to improve maternal health, with a 17% decline in postpartum hospitalizations in states that elected to expand the federal program as of January 2023.
The results showed this reduction in hospitalizations held for the first 60 days postpartum, and there was some evidence of a smaller decrease in hospitalizations between 61 days and six months postpartum.
New data released this year by the United Health Foundation showed racial disparities still exist in maternal health, with severe maternal morbidity twice as high among Black mothers than white mothers.
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.
