Medicaid managed care, maternal mortality review committees, and maternal health: a 12-state scan
- Collection:
- Health Policy and Services Research
- Author(s):
- Schneider, Andy, author Mondestin, Tanesha, author Mathews, Ella, author Akinniyi, Eni, author
- Contributor(s):
- Georgetown University. Center for Children and Families, issuing body.
- Publication:
- [Washington, DC] : Georgetown University Health Policy Institute, Center for Children and Families, October 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Advisory Committees Managed Care Programs Maternal Health Maternal Mortality Medicaid Quality Improvement Socioeconomic Disparities in Health State Health Plans Georgia Illinois Iowa Kansas Kentucky Michigan Mississippi Nevada New Jersey New Mexico Tennessee Washington
- Genre(s):
- Technical Report
- Abstract:
- Each year, more than 40% of all births in the United States are financed by Medicaid, making it the single largest source of coverage for maternity care. Looking more closely, more than 60% of births to all Black women and American Indian/ Alaska Native women are financed by Medicaid. These are the same groups of women who are at greatest risk of maternal mortality and morbidity: data show that Black women, who are disproportionately poor, are nearly three times more likely to die during or just following a pregnancy than White women and Hispanic women, and rates are worsening for all groups. Medicaid’s foundational role in financing maternity care for low-income women makes it an essential part of addressing this maternal health crisis. Of the approximately 1.5 million pregnant women enrolled in Medicaid annually, a large majority are enrolled through Medicaid managed care organizations (MCOs), which organize networks of providers to deliver covered services. For all intents and purposes, these MCOs are the Medicaid program for pregnant women enrolled. MCOs determine whether their pregnant enrollees have timely access to prenatal care; the quality of the hospitals or birthing centers at which the enrollees deliver; whether enrollees have timely access to postpartum services; and, for high-risk enrollees, the availability of effective care management. States are systematically reviewing the causes of maternal deaths through their maternal mortality review committees (MMRCs), which operate in every state except Idaho and involve thorough reviews of deaths of pregnant women and women who die within one year of the end of pregnancy. These committees have helped policymakers understand the scale and urgency of the maternal mortality crisis and have made recommendations to prevent maternal deaths. Our study aimed to answer the question: what information about the performance of individual Medicaid MCOs on maternal health is publicly available? In our scan of Medicaid websites in 12 states, we found that none of the state Medicaid agency websites contained information sufficient to draw firm conclusions as to how well individual MCOs are performing on maternal health generally, or on maternal mortality in particular. The same was true for the MMRC reports we reviewed. Given the ongoing maternal mortality crisis and the central role of Medicaid MCOs as a source of coverage and service delivery for low-income pregnant women in most states, more attention needs to be focused on the performance of those MCOs. Medicaid payments to MCOs represent a major public investment in the health of pregnant enrollees. Without greater transparency, it will not be possible for beneficiaries or the public to hold MCOs (and the state Medicaid agencies that contract with them) accountable for maternal health outcomes among enrollees generally, or for racial and ethnic disparities in particular.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (37 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918733186406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918733186406676