This report examines policy, financing, and programmatic strategies states have implemented to support doula services for Medicaid-eligible individuals.

Background

Maternal mortality rates and poor birth outcomes remain significant concerns in the United States, with persistent racial and ethnic disparities impacting communities of color. Doula services are a potential strategy to address these disparities while generating potential cost savings for state Medicaid programs. This report highlights how four states have implemented doula programs to improve access to care and maternal health outcomes.

About this Resource

This report outlines how four states — Indiana, Minnesota, Nebraska, and Oregon — have supported doula services through Medicaid and other funding streams. The report includes details on how these states approach provider qualifications, reimbursement, and managed care involvement to support Medicaid service enrollment and delivery, or offer doula services as a value-added service covered by managed care or use funds from the Title V Maternal and Child Block Grant to improve outcomes for Black mothers and families. The report includes key learning from state implementation, including the importance of reimbursement rates, clear policies and guidance, and incorporating doulas into planning and evaluation activities.

Program/Policy Takeaways

This report highlights varying policy, financing, and programmatic approaches four states have used to support doula services, an area that has seen significant growth in recent years. Policymakers, state agency staff, managed care organizations, and maternal care providers can learn from the strategies presented in this report to support the implementation of doula services for Medicaid-eligible individuals.