Start: July 2020


The United States is one of only 13 countries in the world where the rate of maternal mortality is worse today than it was 25 years ago. Black women, in particular, are three to four times more likely to die from pregnancy-related complications as white women. As the health insurer for 45 percent of births in the U.S. and 66 percent of all births to Black mothers, state Medicaid agencies have a clear role to play in promoting clinical improvements, enhanced services, and community investments necessary to reduce racial disparities in maternal health outcomes. Medicaid agencies and managed care organizations can support opportunities to implement a high-value, evidence-based maternal model of care such as the midwifery-led model, both in hospitals and in freestanding birth centers. Midwifery-led care may offer a solution to improve health equity and ultimately, maternal and infant outcomes for pregnant individuals.

To promote the adoption of midwifery-led care for addressing disparities in the Medicaid population, the Center for Health Care Strategies (CHCS) is partnering with the Institute for Medicaid Innovation (IMI) on a national virtual learning series. The project will bring together state Medicaid agencies, Medicaid managed care organizations, and midwifery-led practice settings including freestanding birth centers to increase awareness of midwifery-led care, support implementation, and apply key findings from IMI’s report, Improving Maternal Health Access, Coverage, and Outcomes in Medicaid: A Resource for State Medicaid Agencies.

Through a series of collaborative learning sessions, the initiative will provide a roadmap for Medicaid stakeholders to explore next steps for implementation of the midwifery-led maternal care model within their state, organization, and/or practice settings. The session topics are diverse, and will integrate relevant policy discussions such as the changing policy landscape related to COVID-19 and telehealth, Medicaid program changes such as block grants and capitated payments, midwifery and birth center licensure, Medicaid reimbursement policies, and establishing the business case for midwifery-led care.

Look for more resources and updates about this work in the coming months.