New Model Supports White House Blueprint on Maternal Health Crisis and CMS Action Plan
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced innovative actions to improve maternal health and birth outcomes for pregnant and postpartum women and their infants through the new Transforming Maternal Health (TMaH) Model. This 10-year payment and care-delivery model will support participating state Medicaid agencies (SMAs) in developing and implementing a whole-person approach to pregnancy, childbirth, and postpartum care for women with Medicaid and Children’s Health Insurance Program (CHIP) coverage. This model supports the White House Blueprint for Addressing the Maternal Health Crisis and the CMS Maternity Care Action Plan.
“The maternal health crisis in our country is unacceptable. The Biden-Harris Administration is committed to addressing this urgent issue and using all available means to eliminate disparities in our health care system,” said HHS Secretary Xavier Becerra. “This data-driven approach by CMS will help ensure we are improving outcomes for birthing parents and newborns. Expanding access to proven maternal health care best practices and initiatives will help moms and their children thrive.”
“CMS is taking a comprehensive, evidence-based approach to achieve our goal of making tangible improvements in maternal health and birth outcomes,” said CMS Administrator Chiquita Brooks-LaSure. “The Transforming Maternal Health Model furthers our commitment to improve the experience for all pregnant women across the country, regardless of their background and ethnicity.”
Despite spending more per capita for maternity care than any other nation in the world, the U.S. has higher rates of adverse pregnancy outcomes than any other high-income country. The goal of the TMaH Model is to ensure pregnant and postpartum mothers with Medicaid or CHIP health insurance receive personalized care that can improve their health outcomes, including fewer low-risk cesarean sections, and fewer instances of severe maternal morbidity. The TMaH Model also seeks to support or increase access to additional maternal care providers, such as midwives, birth centers, and doula services. Each participating state Medicaid agency will be eligible for up to $17 million during the model’s 10-year period.
“We have heard loud and clear that many women do not feel listened to or supported during their birth experience, and the current rate of maternal morbidity and mortality is deeply concerning,” said CMS Deputy Administrator and Innovation Center Director Liz Fowler. “This model aims to improve health outcomes for mothers and their newborns, and support a system that makes mothers feel empowered, safe, and healthy throughout their pregnancy and postpartum.”
To help mothers feel supported in their birthing plan, states participating in the TMaH Model will increase access to a variety of maternal health providers, such as midwives, freestanding birth centers, and doula services. Participating Medicaid agencies will work with their hospitals and health systems to help achieve the CMS “Birthing-Friendly” designation, which is the first federal quality designation with a focus on maternal health for hospitals and health systems. Additionally, states will foster connections to implement evidence-based practices and lessons, like monitoring pregnant women at home who are diagnosed with conditions that can lead to pregnancy-related complications, such as hypertension and gestational diabetes. Participating states will also have their maternity care providers screen for and address pregnant women’s health-related social needs – including, but not limited to, challenges like inadequate access to nutritious food, housing insecurity, or substance use disorder – by connecting mothers to community-based organizations.
Today’s announcement is the latest in a series of actions CMS is pursuing to further advance maternity care quality, safety, and equity. The Biden-Harris Administration has prioritized maternal health, including by urging all states and territories to provide a full year of continuous postpartum coverage through Medicaid and CHIP under the American Rescue Plan Act. To date, CMS has approved these postpartum coverage extensions in 40 states, plus Washington, D.C. and the Virgin Islands. In addition, the Administration deployed a “Birthing Friendly” designation icon on CMS’s Care Compare online tool to identify hospitals and health systems that participate in a statewide or national perinatal quality improvement collaborative program and that implement evidence-based care to improve maternal health — the first iteration of a federal quality designation with a focus on maternal health for hospitals and health systems.
For more detailed information about the TMaH Model, visit the model website: https://www.cms.gov/priorities/innovation/innovation-models/transforming-maternal-health-tmah-model
To read the TMaH Model Frequently Asked Questions, visit: https://www.cms.gov/tmah-model-frequently-asked-questions
For a fact sheet about the TMaH Model, visit: https://www.cms.gov/files/document/tmah-fs.pdf
Click here for the Journey Map: https://www.cms.gov/files/document/tmah-journey-map.pdf