The District of Columbia’s state Medicaid agency, the Department of Health Care Finance (DHCF), seeks to participate in the Transforming Maternal Health (TMaH) Model to advance our goal of building a maternal health care system that provides whole-person care and improves outcomes.
DHCF pays for almost half of all births in the District and offers a full range of Medicaid services intended to improve maternal outcomes. In recent years, DHCF further expanded efforts to address maternal health, including implementing 12 months of postpartum coverage, doula coverage, and a Maternal Health Advisory Group to provide advice and recommendations. Additionally, the District invested in several initiatives to improve data sharing and perinatal quality monitoring. Yet, we continue to be plagued with below average maternal health outcomes, especially related to preterm birth, maternal mortality, and maternal morbidity. These poor outcomes are felt disproportionately by women of color and women in concentrated geographical regions of the city. We believe TMaH can serve as a catalyst to help the District realize improvements in these maternal health outcomes and address these persistent disparities.
By participating in TMaH, the District will be able to invest in essential care delivery infrastructure and incentivize providers to work together to address a person’s physical, behavioral, and social needs under a sustainable value-based payment. If awarded, DHCF would leverage our requested $17 million budget, over 10 years, to: (1) build staff capacity to implement care delivery and payment reforms; (2) leverage contractor support around practice transformation and actuarial analysis; (3) learn from the experience of our maternal health workforce and beneficiaries; and (4) build provider capacity through infrastructure investments and quality improvement activities.
With TMaH, DHCF intends to center care delivery and payment around the needs of birthing families to ensure the delivery of high-quality care. The critical infrastructure funding and technical assistance from the TMaH Model, supported by a value-based payment model that is patient-centered and equitable, is critical to achieving and maintaining improvements in maternal health outcomes.