- Report reveals gaps in providers and types of services covered
- States asked to improve provider networks, scope of services
State Medicaid programs across the country failed to promote access to health-care services that could have supported better maternal and infant health outcomes, a federal watchdog agency said.
AĀ reportĀ released this week by the US Department of Health and Human Services Office of Inspector General surveyed managed care organizations across 41 state Medicaid programs.
The watchdog found many states didnāt fully leverage Medicaid managed care coverage and access requirements to promote access to maternal health care. The report said many states didnāt require their managed care organizations (MCOs) to cover important types of maternal health providers.
The report comes as the US grapples with some of the worst maternal health outcomes in the developed world. The Centers for Disease Control and Prevention estimates American mothers die at a rate ofĀ 22.3 deathsĀ per 100,000 live births, with non-Hispanic Black women fairing considerably worse, averaging 49.5 deaths under the same metric.
In contrast, Denmark, which has a similar GDP per capita as the US, averagedĀ 4.7 deathsĀ per 100,000 births.
The report also highlighted that some states didnāt require their MCOs to cover certified nurse-midwives, freestanding birth centers, and maternal-fetal medicine specialists even though Medicaid requires that states cover these providers if they are licensed or otherwise recognized by the state.
Only one state out of the 41 queried reported it requires its MCOs to cover all four types of health professionals whose services are optional Medicaid benefits (lactation consultants, community health workers, doulas, and non-nurse midwives) the watchdogs asked about in the survey.
The OIG recommended the Centers for Medicare & Medicaid Services take steps to ensure that all states cover required maternal health services for people enrolled in MCOs.
The watchdog also asked the CMS to clarify statesā requirements to maintain network adequacy standards for OB/GYNs and that the agency support states in tailoring their network adequacy standards to better address maternal health-care needs. Those standards can also include appointment wait times and distance standards.
Medicaid Falls Short on Maternal Health Access, Watchdog Says
October 3, 2024 12:31 pm
State Medicaid programs across the country failed to promote access to health-care services that could have supported better maternal and infant health outcomes, a federal watchdog agency said.
AĀ reportĀ released this week by the US Department of Health and Human Services Office of Inspector General surveyed managed care organizations across 41 state Medicaid programs.
The watchdog found many states didnāt fully leverage Medicaid managed care coverage and access requirements to promote access to maternal health care. The report said many states didnāt require their managed care organizations (MCOs) to cover important types of maternal health providers.
The report comes as the US grapples with some of the worst maternal health outcomes in the developed world. The Centers for Disease Control and Prevention estimates American mothers die at a rate ofĀ 22.3 deathsĀ per 100,000 live births, with non-Hispanic Black women fairing considerably worse, averaging 49.5 deaths under the same metric.
In contrast, Denmark, which has a similar GDP per capita as the US, averagedĀ 4.7 deathsĀ per 100,000 births.
The report also highlighted that some states didnāt require their MCOs to cover certified nurse-midwives, freestanding birth centers, and maternal-fetal medicine specialists even though Medicaid requires that states cover these providers if they are licensed or otherwise recognized by the state.
Only one state out of the 41 queried reported it requires its MCOs to cover all four types of health professionals whose services are optional Medicaid benefits (lactation consultants, community health workers, doulas, and non-nurse midwives) the watchdogs asked about in the survey.
The OIG recommended the Centers for Medicare & Medicaid Services take steps to ensure that all states cover required maternal health services for people enrolled in MCOs.
The watchdog also asked the CMS to clarify statesā requirements to maintain network adequacy standards for OB/GYNs and that the agency support states in tailoring their network adequacy standards to better address maternal health-care needs. Those standards can also include appointment wait times and distance standards.