Transforming Maternal Health Model Implementation & Monitoring

A pregnant woman lies on an exam table during an ultrasound

Testing whether payment and delivery system reform technical assistance can improve maternal health

Client

Center for Medicare & Medicaid Innovation within the Centers for Medicare & Medicaid Servcies
Dates

September 2024 – September 2034

Problem

Compared to other high-income countries, the United States has high rates of adverse pregnancy outcomes.

Women enrolled in Medicaid, including those in underserved communities and rural areas, often experience significant disparities in maternal health care and poor health outcomes for themselves and their newborns.

To address this critical issue, the Centers for Medicare & Medicaid Services (CMS) launched the Transforming Maternal Health (TMaH) Model.

The TMaH Model aims to improve maternal health care for people enrolled in Medicaid and the Children's Health Insurance Program (CHIP) by:

Developing a whole-person approach to pregnancy, childbirth, and postpartum care
Addressing physical, mental health, and social needs during pregnancy
Reducing disparities in access and treatment
Improving outcomes and experiences for mothers and newborns
Reducing overall program expenditures

The model focuses on three main pillars:

Improving access to care, infrastructure, and workforce capacity
Enhancing quality improvement and safety measures
Delivering whole-person care

Solution

NORC is supporting the implementation of the TMaH Model.

Based on NORC’s expertise in designing, implementing, and monitoring maternal and child health innovations, including related value-based payments, we are providing implementation and monitoring support for the TMaH Model. The goal of this work is to develop strategies to energize states and providers to improve care for mothers through technical assistance and new funding mechanisms, while monitoring their progress to make additional and iteratives improvements.

NORC's role includes:

Supporting model implementation across participating state Medicaid agencies (SMAs)
Validating model awardee adherence to program requirements
Collecting and reporting model data, including process, outcome, and milestone measures
Monitoring awardees and their Care Delivery Partners (CDPs)

Supporting CMS on the design and implementation of a value-based alternative payment model, NORC is partnering with the Lewin Group, Bland & Associates, Coral Health Advisors, and University of Minnesota on this contract.

Result

Supporting states as they implement and test reforms will improve maternal health outcomes and reduce related disparities.

Over the first half of the 10-year model, the NORC team will develop and assist with gradual implementation of the alternative payment model, while also determining baseline performance for the last 5 years of implementation. While the long-term impact the TMaH Model is yet to be fully realized, the expected outcomes include:

Improved maternal health outcomes: Through rigorous data collection and analysis, NORC will monitor which strategies and interventions lead to better health outcomes for mothers and newborns.
Reduced health disparities: By monitoring and reporting on access to care and treatment across diverse populations, NORC will support efforts to address and reduce maternal health disparities.
Cost-effective, high-quality care: By assisting in the design and implementation of value-based payment models, NORC will help CMS achieve its goal of reducing overall program expenditures while improving care quality.
Evidence-based policy recommendations: NORC's comprehensive data collection and analysis will provide valuable insights to inform TMaH Model practices and interventions.
Scalable and sustainable model: Through ongoing monitoring and support, NORC will help identify best practices that can be scaled across states, ensuring the long-term sustainability and impact of the TMaH Model.