Unveiling the Transforming Maternal Health Model
by Ellen Van Roekel,
MHA candidate May 2024
CMS's Vision for Tackling the Maternal Health Crisis
In a bid to reshape maternal healthcare and address alarmingly high rates of poor maternal health outcomes (as compared to other high-income countries), the Centers for Medicare and Medicaid Services (CMS) announced the Transforming Maternal Health (TMaH) Model on December 15, 2023. This bold initiative spans a decade, with the goal of improving outcomes for pregnant and postpartum women, all while tackling disparities in access to care and treatment offered.
Who’s In?
The model will support state Medicaid agencies (SMAs) with the development of a whole-person approach to pregnancy, childbirth, and postpartum care. All SMAs are eligible to apply for participation in the model. CMS will ultimately issue cooperative agreements to up to 15 states, offering each selected SMA potential funding of up to $17 million throughout the program's 10-year duration. For selected awardees, the TMaH model presents a dual advantage — a chance to not only improve maternal health, but also realize cost efficiencies.
Anticipated Timeline
CMS will release a Notice of Funding Opportunity (NOFO) in the spring of 2024, with applications due in summer 2024; CMS will then select participating states in fall of 2024. As the payment model takes effect, providers must be contracted with a managed care entity (MCE) or directly with the Medicaid agency in a fee-for-service setting within the designated region implementing the TMaH Model. Participating MCEs in selected states will be able to collaborate with SMAs to create and implement a plan for participation.
CMS will provide targeted support based on state needs via funding and technical assistance. Three years of technical assistance will be provided to the selected SMAs prior to model implementation to ensure successful implementation of the TMaH Model.
Guiding the Way: The Three Pillars
At the core of the TMaH Model are three pillars, each tailored to tackle specific challenges in maternal health. The first pillar, ‘access to care, infrastructure, and workforce capacity’, will focus on person-centric and culturally sensitive care; this involves improved access to essential resources such as midwives, doulas, and perinatal Community Health Workers (CHWs). The second pillar, ‘quality improvement and safety’, requires SMAs to implement evidence-based quality initiatives and protocols known as “patient safety bundles.” These bundles aim to improve outcomes through consistent, evidence-informed practices. Rounding it off, the last pillar, ‘whole-person care delivery’, involves development of a unique birth plan for every mother to promote customized, culturally sensitive care. SMAs will also be required to develop and implement a Health Equity Plan specific to their unique population.
In proposing the TMaH Model, CMS underscores the critical elements of whole-person care, cultural sensitivity, and evidence-based interventions. However, this initiative isn't solely focused on improved outcomes -- it's about establishing a foundation for a more equitable and supportive maternal healthcare system for the nation’s most vulnerable populations. CMS, through its awarded SMAs, is hoping to lead the way in steering transformative change in maternal health, something the healthcare system has struggled to do for decades.
Go to the source(s):
More detailed information: Transforming Maternal Health (TMaH) Model