HHS strengthening early childhood program with $16M infusion
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The Department of Health and Human Services is earmarking roughly $16 million in funds to strengthen Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Programs through seven awards supporting eight states, the agency announced Wednesday.
With funds flowing through the Health Resources and Services Administration (HRSA), the awards are meant to go toward data and technology innovations that support positive maternal and child health outcomes in states and communities, with a focus on addressing health disparities.
The announcement comes as the Biden Administration is recognizing Black Maternal Health Week, which takes place this year from April 11 –17.
Additionally, HRSA is announcing the availability of up to $9 million through the State Maternal Health Innovation and Data Capacity Program to expand the State Maternal Health Innovation and Implementation Program. This program supports state-level development and implementation of strategies geared to improve maternal health and address maternal health disparities.
The funding is expected to help build state capacity to deliver maternity care services, provide training for maternal care clinicians and enhance the quality of state-level data through better collection, reporting and analysis.
The program will fund up to nine cooperative agreements, and each will receive up to $1 million over five years.
WHAT’S THE IMPACT
The MIECHV Innovation awards fall into two categories. About $8 million in American Rescue Plan funding will support four states – Arkansas, Iowa, Virginia and Oklahoma – in developing data and technology approaches that specifically address the impact of COVID-19 on people who are pregnant. The awards will focus on new systems to connect families impacted by the pandemic with social supports, provide home visitors with tailored professional development, and address workforce issues exacerbated by the pandemic.
HRSA will also award about $8 million to four other states – Delaware, Massachusetts, Tennessee and West Virginia – to develop data and technology approaches that improve the delivery of home visiting services. These approaches include developing centralized intake systems to refer families to services and then follow up on those referrals; and developing data dashboards to assist in reporting data by race, ethnicity, language and gender.
HHS’ hope is that the combined $16 million will address social and structural determinants of health, and help reduce disparities in health care access and health outcomes.
At a national level, more than a quarter of MIECHV participants served in FY2021 identified as Black or African American (27.2%), according to the agency.
The funding builds on the $82 million in American Rescue Plan funds to expand home visiting assistance for families affected by the COVID-19 pandemic announced in December 2021, and the $40 million in American Rescue Plan funds that were distributed in May 2021.
ACTIONS TO REDUCE MATERNAL MORTALITY
The awards aren’t the only steps being taken by the administration to address maternal issues. Also on Wednesday, the Centers for Medicare and Medicaid Services released more details about the proposed “Birthing-Friendly” hospital designation intended to drive improvements in maternal health outcomes.
The new designation would assist consumers in choosing hospitals that have demonstrated a commitment to maternal health and the delivery of high-quality maternity care. Additional information about the initial requirements for the designation will be released in the coming days as a part of the Hospital Inpatient Prospective Payment System (IPPS) proposed rule.
Louisiana, Virginia, New Jersey and Illinois have started offering Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy. CMS is also working with another 11 states and Washington D.C. to extend postpartum coverage for 12 months after pregnancy, including California; Washington D.C.; Indiana; Kentucky; Maine; Michigan; Minnesota; Oregon; New Mexico; South Carolina; Tennessee and West Virginia.
If the efforts are successful, as many as 720,000 people across the United States could be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy, said CMS.
Initially, the publicly reported maternity care quality hospital, or “Birthing-Friendly” designation, would be based on a hospital’s attestation to the Hospital Inpatient Quality Reporting (IQR) Program’s Maternal Morbidity Structural Measure, which CMS sees as a first step committing hospitals to the quality and safety of maternity. The reporting period began in October 2021, and data will be submitted by hospitals for the first time in May 2022. CMS will post the Maternal Morbidity Structural Measure data for October to December 2021 in fall 2022, and post initial results for the hospital designation beginning in fall 2023.
The agency intends to expand the criteria for which this designation would be awarded in the future. The designation, which would appear on a CMS website, would ultimately assist consumers in choosing hospitals that have demonstrated a commitment to maternal health through their participation in quality improvement collaboratives.
THE LARGER TREND
Making inroads in addressing maternal health has been a priority for the current Congress, which in August 2021 advanced a budget resolution that allows for investments in healthcare that include sexual and reproductive care.
The resolution unlocked the reconciliation process, by which Congress can expand Medicaid – providing health coverage to an estimated four million people who are currently uninsured, reduce costs, address the maternal health struggles and make more investments in health equity.
Planned Parenthood president and CEO Alexis McGill Johnson said at the time that the COVID-19 pandemic has highlighted the fragility of access to sexual and reproductive healthcare.
Private insurers have also made some moves in this direction. In late June, UnitedHealth Group subsidiary Optum awarded $1.4 million in maternal health grants, pledging to provide pro bono services to five community organizations aimed at improving maternal health outcomes and increasing healthcare access for underserved populations.
The grants are part of several initiatives by Optum and UnitedHealth Group to address maternal health outcomes and disparities across the U.S. They include a $3 million contribution to help improve access to prenatal care in underserved communities in New York and a $2.6 million grant in Nevada to reduce maternal health disparities and help grow the state’s OB-GYN and family medicine physician workforce.
More recently, in November, HHS announced that more than 200 hospitals have signed on to a new program, Perinatal Improvement Collaborative, a contract with Premier. The new network, focused almost exclusively on reducing such disparities, is composed of hospitals from all 50 states. HHS says it’s the first to evaluate how pregnancy affects overall population health by linking inpatient data of newborns to their mothers.
The Lancet found that the U.S. has the highest maternal mortality rate of all developed countries, and is the only industrialized nation with a rising rate.
According to the Centers for Disease Control and Prevention, 60% of pregnancy-related deaths are thought to be preventable, and patients of color face the greatest risk of death and complications. Multiple factors contribute to these disparities, including variation in quality healthcare, underlying chronic conditions, structural racism and implicit bias.
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