Maternal health in the US is in a severe state. If you’re reading this, you’re likely familiar with the statistics. In brief, despite spending more money per capita on maternity care than any other country, the US has worse maternal health outcomes than all high-income countries.

There have been multiple rallying cries to do something about this horrific status quo. Perhaps most influential among them was the CDC’s 2022 report, which stated over 80% of these deaths were avoidable. Additionally, the problem is worse for birthing people of color.

Pause for just a minute and think about that statistic.

Over 80% of maternal deaths were avoidable.

That means if ten people died as a result of pregnancy or postpartum complications, at least eight could still be alive today if better care practices were in place.

Policies are a critical lever for change. But as I’ll detail here, policy alone is not enough.

What Is Transforming Maternal Health?

In December, CMS announced its new effort to improve maternal health outcomes: The Transforming Maternal Health (TMaH) Model. The announcement detailed that CMS will issue awards for up to 15 states where State Medicaid Agencies (SMAs) will receive up to $17 million in funding for a ten-year period. States are required to implement certain elements of the TMaH model to receive the payments. These include the following, among other things:

  • Perform risk assessment, referral, and follow-up for perinatal depression, anxiety, tobacco, substance use, and health-related social needs (a.k.a. drivers of health)
  • Provide home monitoring of diabetes and hypertension
  • Develop a health equity plan
  • Provide access to midwives, birth centers, and coverage for doulas
  • Improve data infrastructure and payment models
  • Implement patient safety protocols and promote “Birthing-Friendly” designation

Coverage of evidence-based services and implementation of these stated capabilities is a great start. But it’s truly just a start. For example, including social needs assessments and referrals is good, but as detailed in our research report, You are what you treat, this isn’t sufficient to improve health outcomes. An entity must have a supportive business model in place to move the lever. (See the report for the types of business models that do this effectively.)

Additionally, home monitoring, a health equity focus, coverage of midwifery and doula services are also great investments that demonstrate a willingness to put evidence-based practices in place. For example, we know access to doula care—both virtual, and in-person—improves health outcomes.

But, as a nation, we must do more to achieve the goal of reduced maternal mortality. The Tools of Cooperation framework details why this is the case.

Read the full article about maternal health policy by Ann Somers Hogg at Christensen Institute.