HealthCalifornia to participate in Transforming Maternal Health Model

California to participate in Transforming Maternal Health Model

Overview: California has been selected by the Centers for Medicare & Medicaid Services (CMS) to participate in a new model aimed at improving maternal health outcomes for beneficiaries enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The Transforming Maternal Health (TMaH) Model will focus on reducing disparities in access and treatment while reducing overall program expenditures. The initiative aligns with California’s commitment to reducing maternal mortality and morbidity, ensuring healthier futures for families across the state.Breanna Reeves
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In an effort to double down on improving maternal health outcomes in the state, California was selected by the Centers for Medicare & Medicaid Services (CMS) to participate in a new model that will take a “whole-person approach” to pregnancy, childbirth and postpartum care.California was one of 15 states chosen to implement the Transforming Maternal Health (TMaH) Model. TMaH is a 10-year initiative that will focus specifically on improving maternal health care for beneficiaries enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). According to the model overview, the goal of TMaH is to reduce disparities in access and treatment while also reducing “overall program expenditures.”“The CMS Transforming Maternal Health grant strengthens California’s leadership and innovation while taking a crucial step toward reducing health disparities and ensuring mothers in the Central Valley have access to equitable care,” stated California Surgeon General Dr. Diana Ramos in a press release. “This initiative aligns with our shared commitment to reducing maternal mortality and morbidity, ensuring healthier futures for families across California.”While the U.S. spends more money per person on maternal health, the nation had the highest rates of maternal mortality and infant mortality compared to other high-income nations, according to an analysis by The Commonwealth Fund. A report published by KFF noted that in 2021, the U.S. spent $12,914 per person in health care spending, the highest among higher-income countries. Among the U.S. rate, Black women have the highest rate of maternal mortality. The TMaH model is being launched in five Central Valley counties that were identified as having the greatest need for intervention: Fresno, Kern, Kings, Madera and Tulare.“By targeting these high-need counties, we are taking a strategic step toward improving the health and well-being of pregnant people across California, particularly in areas experiencing the greatest maternal health disparities,” stated Department of Health Care Services Director Michelle Baass in a statement.Kern, Kings and Madera Counties were identified by the March of Dimes 2024 Report Card as “very high” on the Maternal Vulnerability Index, which is used to understand where and why birthing people may be more likely to have poor health outcomes. According to the report card, birthing people in California are most vulnerable to poor outcomes due to their physical environment and social and economic determinants of health (income, housing, food access, education, etc).“This model will allow us to test innovative approaches to maternal health care, ensuring that every pregnant Medi-Cal member, regardless of their background or circumstances, receives the care they need to have a healthy pregnancy and delivery,” Baass stated. “Participation in TMaH will advance DHCS’ ability to achieve its maternal health priorities and continue investing in the future of equitable birthing care.”TMaH will support Medi-Cal enrollees with funding and technical assistance, which will also allow California to develop an alternative payment model for maternity care services. The model will focus on three main pillars: access to care, infrastructure and workforce capacity; quality improvement and safety; and whole-person care delivery.By implementing evidence-based interventions “within a value-based payment (VBP) framework,” providers will be reimbursed based on patient health outcomes and quality of care, rather than the number of services provided. The TMAH model aims to reduce low-risk cesareans, lower severe maternal morbidity, and increase access to maternal providers such as midwives, doulas,and birth centers.The TMaH Model will award $17 million in funding over the program’s 10-year course. CMS will award this funding to DHCS in two phases: $8 million during the three-year pre-implementation period (2025-2027) and $9 million during the seven-year implementation period (2028-2035). Within the model, Medi-Cal, along with Managed Care Organizations (MCOs), Perinatal Quality Collaboratives, hospitals, birth centers, health centers and rural health clinics, maternity care providers and community-based organizations will work together as “collaborators” to ensure the model is a success in improving maternal health outcomes.The TMaH Model is another addition to the state’s effort to address maternal health outcomes, now joining DHCS’S Birthing Care Pathway, an initiative that supports the journey of a Medi-Cal member from conception through 12 months postpartum.
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Source: Black Voice News

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