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As part of the Biden Administration’s bid to improve health outcomes and reduce disparities for people during and after pregnancy and childbirth, the Centers for Medicare and Medicaid Services has announced a Maternity Care Action Plan – saying it will take a more holistic and coordinated approach to such care.
On top of that, CMS approved new actions in Connecticut, Kansas and Massachusetts to extend Medicaid and Children’s Health Insurance Program coverage for 12 months after pregnancy. The agency estimates this will result in up to 19,000 people annually in these states – including 4,000 in Connecticut; 7,000 in Kansas; and 8,000 in Massachusetts – having access to Medicaid or CHIP coverage for a full year after pregnancy.
Through the action plan, CMS Administrator Chiquita Brooks-LaSure encouraged industry stakeholders – including healthcare facilities, insurance companies, state officials and providers – to consider key commitments the private sector can make to improve maternal health outcomes.
WHAT’S THE IMPACT? MEDICAID, CHIP EXTENSION
The extension of coverage was facilitated by a new state plan opportunity established by the American Rescue Plan. The states extending postpartum coverage join California, Florida, Illinois, Kentucky, Louisiana, Maine, Michigan, Minnesota, New Jersey, New Mexico, Oregon, South Carolina, Tennessee, Virginia; D.C. and Washington state in extending Medicaid and CHIP coverage from 60 days to 12 months after pregnancy.
According to agency figures, this means an estimated 284,000 parents are eligible for 12 months of postpartum coverage through the extensions. If all states adopted this option, CMS said, as many as 720,000 people across the U.S. annually could be guaranteed Medicaid and CHIP coverage for one year after pregnancy.
The administration has said that it will do what it can to ensure access to the full range of reproductive healthcare services in light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturning Roe v. Wade and abortion rights.
These services include IUDs, emergency contraception, other forms of contraception and abortion care within the agency’s legal authority (in cases where the individual’s life is in danger, or in cases of rape or incest).
‘BIRTHING FRIENDLY’ HOSPITALS
CMS has also outlined a proposal for a “Birthing-Friendly” hospital designation as part of its maternal health strategy in the 2023 Inpatient and Long-term Care Hospital Prospective Payment System proposed rule released this year.
The designation would be publicly displayed on a CMS website to provide information to consumers on hospitals that have implemented best practices for pregnant and postpartum patients.
Initially, the designation would be awarded to hospitals based on their reporting of the Maternal Morbidity Structural Measure in the Hospital Inpatient Quality Reporting (IQR) Program. The proposed rule also introduces two additional maternal health quality measures for the Hospital IQR Program regarding low-risk Cesarean deliveries and severe obstetric complications.
As part of the maternal health plan, CMS said it’s also working to expand its data collection efforts, build a better understanding of key demographic drivers of health to identify disparities in care or outcomes, and coordinate across programs to identify gaps and best practices.
CMS said it will also engage with states, providers and other stakeholders to improve maternal care among Medicaid, CHIP, Medicare and Health Insurance Marketplace enrollees, and with states and sister agencies to expand and improve access to the maternity care workforce, including midwives and community-based practitioners such as doulas and community health workers.
Yesterday, the Department of Health and Human Services Office of the Assistant Secretary for Health announced it was investing $8.5 million in initiatives designed to reduce pregnancy-related deaths and complications that disproportionately impact minority populations and those living in rural areas. OASH announced 25 winners of the first phase of the HHS Racial Equity in Postpartum Care Challenge. American Indian/Alaska Native and Black women are two to three times more likely to die from a pregnancy-related cause than Caucasian women, the agency said.
THE LARGER TREND
The current administration has backed a number of policies aimed at improving maternal health. Last year, President Biden issued the first-ever presidential proclamation marking Black Maternal Health Week. It is coupled with a set of initial actions to address the Black maternal health crisis. Vice President Kamala Harris hosted the first-ever White House Day of Action on maternal health.
In addition, the Department of Health and Human Services recently issued a new final rule for Title X, the nation’s family planning program, to ensure access to affordable family planning services.