Of the 5.1 million Alabama residents, there are approximately 58,000 births per year according to the National Vital Statistics Center. Alabama has seen a decline in births since 2022 by .6% according to the Centers for Disease Control and Prevention/Stateline Analysis. According to CDC data, Alabama had a maternal mortality rate (MMR) of 36.4 maternal deaths per 100,000 live births in 2019—one of the highest in the nation.
However, data show that the maternal health crisis in Alabama is potentially more significant. The 2016 Alabama-Maternal Mortality report revealed a maternal death ratio of 49.1 per 100,000 live birth and pregnancy-related mortality ratio of 59.2 per 100,000 live births. Black women in Alabama are at higher risk of facing complications in health outcomes, disparate access to prenatal care, and higher rates of preterm birth than their white counterparts.
The Transforming Maternal Health (TMaH) Model aims to improve access to care, grow the workforce, and deliver equitable, patient-centered care through partnerships with various stakeholders. If awarded, the Alabama Medicaid Agency (Medicaid) seeks to study current clinical and patient access systems, modernize data processes, and create a system of whole-person, patient-centered care. With funding from TMaH, Medicaid will commit to quality improvement and patient safety within hospitals and across the state. Additionally, the plan includes creating regional partnerships in rural areas, maintaining postpartum Medicaid to 12 months, promoting shared decision-making, and increasing the use of home visits, mobile health, and telehealth.
The development and adoption of new models of value-based payment would be a step toward increasing access to care, improved maternal outcomes, care team collaboration, and reduction in healthcare costs. Alabama is in a strong position to use funding to truly build infrastructure in the state that will enhance the programs that are working, improve the programs with potential, and test innovative practices over the next ten years.
Key Words: Medicaid, maternity, infrastructure, quality improvement
