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CMS intends to propose a national
“Birthing-Friendly” hospital designation on the Hospital Compare section of
the CMS Care Compare website, and also encourages states to provide 12
months postpartum coverage to people with Medicaid and CHIP
As
part of Vice President Kamala Harris’s Call to Action to Reduce Maternal
Mortality and Morbidity, the U.S. Department of Health and Human Services
(HHS), through the Centers for Medicare & Medicaid Services (CMS), is
taking steps to improve maternal health and support the delivery of
equitable, high-quality care for pregnancy and postpartum care. CMS intends
to propose a “Birthing-Friendly” designation to drive improvements in
perinatal health outcomes and maternal health equity. The designation would
initially identify hospitals that provide perinatal care, are participating
in a maternity care quality improvement collaborative, and have implemented
recommended patient safety practices.
In
addition, CMS is encouraging states to take advantage of the American
Rescue Plan’s (ARP’s) option to provide 12 months postpartum coverage to
pregnant individuals who are enrolled in Medicaid or the Children’s Health
Insurance Program (CHIP). This follows the release of a report by HHS’s
Office of the Assistant Secretary for Planning and Evaluation (ASPE)
showing the dramatic impact if states extended Medicaid postpartum coverage
to 12 months. If every state adopted an extension — as proposed in the
Build Back Better Act — then the number of Americans getting coverage for a
full year postpartum would roughly double, extending coverage for an
estimated 720,000 in a given year.
Medicaid
and CHIP cover over 42
percent of births in the nation, nearly half of which are to Black,
Hispanic, or American Indian/Alaskan Native individuals. Extending the
postpartum coverage period can improve health outcomes during the
postpartum period and mitigate health disparities for individuals served by
Medicaid and CHIP.
“As
a father to three daughters and husband to a high-risk obstetrician, I know
nothing is more important as having healthy childbirth,” said HHS Secretary
Xavier Becerra. “I’m proud that the Biden-Harris Administration has made maternal
health and equity a priority. We will continue to take actions to support
new parents and ensure safe pregnancies, no matter a family’s background.”
“No
mother should have to fight for her coverage or care during pregnancy or
while caring for a newborn. CMS is doing everything we can to support the
health of new parents and families, and to advance health equity across the
country,” said CMS Administrator Chiquita Brooks-LaSure. “Across the
Biden-Harris Administration, we are committed to advancing equitable,
high-quality maternity care, and reducing unnecessary postpartum illnesses
and deaths that disproportionately harm people of color.”
Beginning
with discharges on October 1, 2021, CMS adopted a new structural quality
measure for the Hospital Inpatient Quality Reporting Program that asks
hospital to attest to whether they participate in a statewide and/or
national maternal safety quality collaborative and whether they have
implemented the recommended patient safety practices or bundles to improve
maternal outcomes. Through this measure and others CMS intends to propose,
a hospital could be considered “Birthing-Friendly” with special designation
on CMS’ “Care Compare” website.
Maintaining
Medicaid and CHIP coverage for an extended period of time can help address
persistent disparities that exist in pregnancy-related
morbidity and mortality. One-third of maternal deaths occur between one
week to a year after childbirth, and rates are especially high among Black
women and American Indian/Alaska Native individuals. Expanded coverage
helps to ensure access to the ongoing care people need during the
postpartum period. It will also help individuals in the postpartum period
manage chronic conditions like hypertension and diabetes, and provide
access to behavioral health services.
Currently,
Medicaid beneficiaries are entitled to continuous coverage through the end
of the month in which their 60-day postpartum period ends. In states that
adopt the new extended postpartum coverage option, individuals who are
enrolled in Medicaid or CHIP while pregnant will be eligible for 12 months
of extended postpartum coverage. Additional individuals who will benefit
from a state’s election are those whose pregnancy ended within three-months
of their application for Medicaid and who would have been eligible when
their pregnancy ended had they applied earlier.
The
State Health Official letter includes guidance and resources for states
that take up the state plan option to ensure that the extended coverage
leads to improved health outcomes for postpartum individuals. CMS is
available to provide technical assistance to states as they extend
postpartum coverage, implement innovative payment and delivery system
efforts, and engage in initiatives to measure and improve quality aimed at
addressing the needs of pregnant and postpartum beneficiaries. States that
elect to provide the extended postpartum coverage option are encouraged to
educate beneficiaries about the availability of extended postpartum
coverage.
To
read the HHS ASPE Issue Brief, visit: https://aspe.hhs.gov/reports/potential-state-level-effects-extending-postpartum-coverage
For
more information about the Maternal Morbidity Structural Measure go to: https://www.cms.gov/files/document/maternal-morbidity-structural-measure-specifications.pdf
To
see a copy of the State Health Official Letter, please visit: https://www.medicaid.gov/federal-policy-guidance/downloads/sho21007.pdf.
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