On July 26, the Centers for Medicare & Medicaid Services (CMS) revealed via a press release its Maternity Care Action Plan that aims to support the implementation of the Biden-Harris Administration’s “Blueprint for Addressing the Maternal Health Crisis.” This action plan follows the U.S. Supreme Court’s June 24 Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade.
The press release says that “The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.”
Additionally, CMS approved new actions in Connecticut, Kansas, and Massachusetts to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy. A total of 19,000 individuals in these states will have annual access to Medicaid or CHIP. The extension of coverage comes from the American Rescue Plan and the states join California; Florida; Illinois; Kentucky; Louisiana; Maine; Michigan; Minnesota; New Jersey; New Mexico; Oregon; South Carolina; Tennessee; Virginia; Washington, D.C.; and Washington state in extending Medicaid and CHIP to 12 months after pregnancy. It is estimated that a total of 284,000 parents are eligible for the coverage. If all states in the country adopt this option, according to the release, 720,000 people could have Medicaid and CHIP coverage for 12 months after pregnancy.
“Access to care across the lifespan is crucial to women’s health and birth outcomes,” the release adds. “In light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, CMS is working to ensure access to the full range of reproductive healthcare services—including 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).”
Further, the release announces that CMS also has outlined its proposal for a “Birthing-Friendly” hospital designation in the 2023 Inpatient and Long-term Care Hospital Prospective Payment System proposed rule released earlier this year. The designation will be available on a CMS website that provides information to consumers on hospitals that have demonstrated a commitment to maternity care quality by using best practices that advance healthcare quality, safety, and equity for pregnant as well as postpartum patients.
The release states that, “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.”
That said, “Postpartum coverage extensions, the new “Birthing-Friendly” hospital designation, and additional quality measures are just several of the diverse tools comprising the CMS Maternity Care Action Plan, including:
- Coverage and Access to Care: CMS is working to improve access to comprehensive health coverage, including for those eligible through Medicaid and CHIP, the Health Insurance Marketplace®, and Medicare coverage; and to help ensure continuity of coverage from before, during, and after pregnancy.
- Data: CMS is 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.
- Quality of Care: As we develop new policy, CMS will engage with people with lived experience, and work with states, providers, and other key stakeholders to improve the quality of care that Medicaid and CHIP, Medicare, and Health Insurance Marketplace® enrollees receive during pregnancy, childbirth, and postpartum.
- Workforce: CMS will work with states and sister agencies to identify opportunities to expand and improve access to a diverse maternity care workforce, including midwives and community-based practitioners, such as doulas and community health workers.
- Social supports: CMS will work to build connections between the care and supports CMS programs cover and the social supports provided by other federal, state, and local partners, with the goal of providing whole-person care to pregnant and postpartum enrollees.”
CMS Administrator Chiquita Brooks-LaSure is encouraging industry stakeholders—including healthcare facilities, insurance companies, state officials, and providers—to think about commitments the private sector can make to enhance maternal health outcomes. Industry can submit proposed commitments at http://cms.gov/maternalhealthcommitments.
Brooks-LaSure is quoted in the release saying that “The United States is facing a worsening maternal health crisis. Enough is enough. We can—and will —do better. CMS will use every available lever to support people during pregnancy, childbirth, and the postpartum period, and advance health equity across the country. Our action plan is built on promising approaches, like extending postpartum coverage in Medicaid, which already covers more than 40 percent of births nationwide, to advance equitable, high-quality maternity care and reduce unnecessary maternal illnesses and deaths.”