Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis
Patti Boozang, Chiquita Brooks-LaSure, and Gayle Mauser, Manatt Health
Medicaid has a pivotal role in improving national health outcomes for pregnant and postpartum women. Nearly half of all U.S. births are financed by Medicaid. Medicaid-enrolled pregnant women are more likely than women enrolled in private coverage to have had a preterm birth, to have had a low birthweight baby, and to experience certain chronic conditions (e.g., diabetes)—putting them at higher risk for poor maternal outcomes. States have flexibility to shape Medicaid policy related to maternal care, including who is covered, the duration of their coverage, the benefits they receive, and the delivery system through which they receive care. Further, state Medicaid agencies, in partnership with sister agencies, can use their purchasing power and “bully pulpit” to drive broader policy and cultural change to improve maternal health outcomes and the lives and health of mothers and of their children.
This issue brief, developed by our colleagues at Manatt Health, describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities in five areas: coverage, enrollment, benefits, models of care, and quality improvement. In some cases, the Medicaid agency will be responsible for implementing these policies; in other cases, the Medicaid agency can lead collaboration with other state agencies such as the public health department or the state marketplace.
On March 11, State Health and Value Strategies hosted a companion webinar that highlighted and discussed select strategies from the issue brief.
In this new expert perspective series, State Health and Value Strategies will highlight examples of the work states are engaging in to prepare for and operationalize the unwinding of the continuous coverage requirement to minimize coverage losses. This new series aims to showcase strategies that other states may be interested in adopting and highlight how states are leveraging federal flexibilities.
The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, five states—Iowa, Minnesota, Utah, Washington, and West Virginia—have publicly released some type of unwinding data (this includes states reporting unwinding data in both a dashboard and a static format, but not states with pre-existing enrollment dashboards that don’t specifically identify unwinding cohorts). SHADAC will update this expert perspective as additional dashboards go live.
To maximize efforts to maintain coverage, state Medicaid agencies and Marketplaces can now leverage digital channels as part of their overall outreach and communications efforts. Rapidly evolving changes in consumer media consumption habits as well as shifts in digital channels, and the ability to leverage data sources, enables granular audience targeting and efficient use of resources. These can be incorporated into an overall integrated outreach and education campaign to maximize renewals and coverage retention.