New Roadmap & Checklist on High-Value, Evidence-Based Maternal Models of Care in Medicaid

Jennifer E. Moore, PhD, RN, FAAN

As the nation focuses on addressing the alarming rates of maternal mortality and morbidity, state Medicaid agencies, Medicaid health plans, clinicians, and other stakeholders are seeking to identify the root causes of the disparities and identify high-value, evidence-based maternal models of care that can be piloted and scaled-up. Through a comprehensive and multi-year analysis conducted by the Institute for Medicaid Innovation, we discovered that community-based models, specifically ones that identified midwifery-led care as the standard with doulas and perinatal community health workers, had better outcomes for low-risk pregnant and birthing individuals and higher social and financial return-on-investment. With decades of research data that demonstrate the value, the question that many are wondering is why this model of care is not more widely used? Upon deeper investigation, we noted several barriers as highlighted in our groundbreaking report, “Improving Maternal Health Access, Coverage, and Outcomes in Medicaid: A Resource for State Medicaid Agencies and Medicaid Managed Care Organizations.”

The report was followed by an 8-part virtual learning series that elevated key concepts in the report in an interactive format with national experts. The topics covered and resources developed for each session can be accessed using the following links.

• Session 1: High-Value, Evidence-Based Maternal Models of Care and Birth Equity
• Session 2: Value Proposition for Midwifery-Led Care in Medicaid
• Session 3: Licensure, Credentialing, and Contracting in Medicaid
• Session 4: Launching and Operating Medicaid Focused Midwifery-Led Models of Care
• Session 5: Aligning State Medicaid Initiatives with Midwifery-Led Models of Care
• Session 6: Building the Business Case to Support Birth Equity & Spark Policy Momentum
• Session 7: Value-Based Purchasing and Alternative Payment Models: Payment Reform for Midwifery-Led Care
• Session 8: Roadmap for Success: Action Steps for Launching High-Value, Evidence-Based Maternal Models of Care

At the culmination of the learning series, we recognized the need to develop a roadmap with tangible action steps that every Medicaid stakeholders can take to advancing midwifery-led models of care. Advancing high-value, evidence-based maternal models of care require each Medicaid stakeholder to conduct a self-assessment to identify their individual role before they can establish an action plan to support the collective effort. The roadmap infographic serves as an environmental scan to highlight the different types of stakeholders who are essential for the effort. It requires each stakeholder to look broadly outside of their space to identify opportunities and challenge to elevate the identified facilitators and mitigate barriers to achieve success. The checklist offers a comprehensive and interactive tool for each Medicaid stakeholder to start the journey or enhance their current efforts.

As IMI continues to lead the Medicaid and Maternal Health Hub for the nation, we will be launching a national learning collaborative that will build upon the previous reports, learning series, and tools to provide intensive, one-on-one support and resources to facilitate the work of state-based teams.