Medicaid insurers 'missing opportunities' to improve maternal care
The U.S. is experiencing a maternal health crisis, and has worse outcomes than in any other high-income country, according to OIG.
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States could do more to require Medicaid managed care organizations (MCOs) to improve access for maternal health, according to an Office of Inspector General report.
States are not leveraging managed care provider coverage requirements and network adequacy standards to promote access to maternal healthcare, the OIG found.
All states require their MCOs to cover obstetrician/gynecologist (OB/GYN) physicians and hospitals, but many states reported they do not require MCOs to cover other types of maternal health providers and professionals, some of whose services are federally required, the OIG said.
WHAT'S THE IMPACT?
The U.S. is experiencing a maternal health crisis, and it has worse outcomes than does any other high-income country, according to the report. Significant racial and geographic disparities exist in maternal deaths and complications.
Medicaid is the nation's largest maternal healthcare payor, and most pregnant enrollees are covered by MCOs.
THE LARGER TREND
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.
The Department of Health and Human Services has taken several steps to address the maternal health crisis, including the Perinatal Improvement Collaborative, in a contract with Premier. More than 200 hospitals agreed to participate in the program targeting maternal and infant health outcomes.
The Maternal Morbidity and Mortality Data and Analysis is part of that initiative. In an $8 million contract with Premier, HHS, Office on Women's Health created a network of at least 200 hospitals to deploy clinical, evidence-based best practices in maternity care. The data on the program is meant inform policy and validate evidence-based practice to improve maternal and infant health outcomes. Each of the participating hospitals was asked to capture more than 150 clinical and nonclinical measures that affect health outcomes.
Rates of adverse maternal outcomes vary across hospitals, according to a report published in the National Library of Medicine.
Correction: This story has been updated to reflect that key maternal health metrics are attributed to HHS, and that inconsistencies among hospitals in reporting maternal health outcomes were sourced from the National Library of Medicine's National Center for Biotechnology Information. Healthcare Finance News apologizes for previously misstating the sources of that data.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
