Last fall, I attended the Institute for Medicaid Innovation’s (IMI) Maternal Health Policy Equity Summit. The goal of the summit was to establish “a blueprint for improving maternal and infant health outcomes under Medicaid”. Given UnitedHealthcare Community & State’s strong support of maternal health initiatives, I participated in the summit with other Medicaid policy and practice stakeholders to discuss strategies to improve perinatal and maternal health for those accessing their health care coverage through the Medicaid program.1
Federal and state policymakers have worked to improve health outcomes through community-based models and an extension of 12-month postpartum coverage. The aim of the IMI summit was to build upon this momentum, developing a strategic five-year plan to significantly improve outcomes.2
To inform the focus of the summit, a national survey was completed by representatives at state and federal agencies, Medicaid health plans, national maternal child health leaders, maternal health providers and Medicaid consumers. The purpose of the survey was to determine priority topics for the summit. The following four topics were identified:
- Maternal mental health
- Doulas and perinatal community health workers
- Midwifery-led models of care
- Prenatal care and coverage to age 3
Background papers on each of the four priority topics were developed to provide foundational knowledge for summit participants. During the event, presentations offered federal and state perspectives, and stories were shared by Medicaid consumers who had experienced a pregnancy.
From these presentations and the discussions from the two-day summit, a summative report was developed to launch the new Medicaid maternal health plan agenda. The report details a five-year plan to change the trajectory of maternal health in the U.S. It includes priority topic background papers, an overview of current Medicaid maternal health policy, guiding pillars to improve health outcomes, “Five Big Ideas” to initiate the new agenda, policy opportunities and next steps.
The “Five Big Ideas” and a few noted policy opportunities include:
- Build, sustain and support the workforce
- Policy opportunity: ensure equitable and sustainable reimbursement for all doulas
- Integrate services and systems across settings and sectors
- Policy opportunity: support the development of infrastructure that strengthens the collaborative, team-based workforce in maternity care
- Collect the right data and make it open source
- Policy opportunity: include perinatal mental health screening and treatment quality metrics in Medicaid health plan contracts, facilitated by adding measures into the HEDIS core set and reporting statewide data publicly
- Establish the foundation for a family-based continuum of care from preconception to age 3
- Policy opportunity: adopt continuous-enrollment policies beyond one year to eliminate gaps in Medicaid coverage
- Learn from and build on emerging ideas at the community and state levels
- Policy opportunity: launch public education and awareness campaigns on the benefits of midwifery with emphasis on community power-building
The report concludes that the next step in improving national maternal and infant health outcomes is to act on the five main points highlighted, ensuring that health equity and accountability are prioritized.
A recording of an overview of the summit can be viewed here.
