Medicaid Reform Lies at the Heart of Efforts to Address the US Maternal Health Crisis

May 25, 2023

The Road to Maternal Health Runs Through Medicaid Managed Care

WASHINGTON (May 25, 2023)--Medicaid must be part of any solution to address the current maternal mortality crisis and racial inequities in the United States, according to a new analysis by researchers at the George Washington University.

The authors note that in 2021 Medicaid paid for 41% of all births. In addition, they say that improving maternal health for Medicaid beneficiaries must involve Medicaid managed care plans, which together enroll more than 70% of all Medicaid beneficiaries nationwide.

To better understand the relationship between managed care performance and maternal health, the researchers analyzed Medicaid contracts from all states that used comprehensive managed care in 2022. To guide their review, the GW team also conducted an extensive review of maternal health best practices and research studies from pre-pregnancy through the postpartum period.

The team found that Medicaid managed care contracts tended to approach the maternal health continuum in a fragmented and incomplete way. In addition, contracts reflected variation among states in how key aspects of maternal health were being addressed.

Based on the research, whose detailed findings and contract tables are fully available online to readers, the authors make several recommendations for Medicaid plans, states and the Centers for Medicare and Medicaid Services. They say managed care and maternal health can be improved by fully incorporating maternal health continuum care into contracts, which serve as blueprints for establishing and overseeing performance.

The authors also urge development by CMS, working with states, plans, providers, experts, and consumers, of fully integrated maternal health guidelines across the full continuum of care, a step that could immeasurably aid in the development of effective improvement strategies. 

Such guidelines, they note, could be accompanied by a formal best practices initiative that shares innovative approaches to managed care and maternal health to ensure access to the full maternal health continuum.

Read more about the analysis, in a blog published by the Commonwealth Fund titled “The Road to Maternal Health Runs through Medicaid Managed Care Plans.” Sara Rosenbaum, Professor Emerita of Health Law and Policy, Anne Markus, Professor & Chair of the Department of Health Policy and Management, Caitlin Murphy, Rebecca Morris, and Maria Casoni, all researchers at the GW Milken Institute School of Public Health, and Kay Johnson, a national maternal and child health expert authored the blog and conducted the research.