This article was written in collaboration with Nicole Andrzejewski, Director of Medicaid Partnerships at Maven Clinic.
In the United States, Medicaid covers a significant portion of births. In 2021, two out of five people who gave birth in the U.S. used Medicaid as their primary form of payment. The U.S. faces a maternal mortality crisis and expanding access to Medicaid can reduce maternal deaths by improving access to care for underinsured populations.
Maven has partnered with Medicaid plans for multiple years to provide better, comprehensive care to members as they start and raise their families. While improving care for this population can be complex, we’ve gathered four key learnings that can improve maternity care for Medicaid beneficiaries.
Lessons learned: Women’s and family health for Medicaid populations
Lesson 1: There is a dire need for maternal mental health support
Mental health is deteriorating in the U.S. in general, and people who use Medicaid have been affected particularly hard by this epidemic. Over 40% of Maven Medicaid members report that they have symptoms of anxiety or depression during their pregnancy*, compared to 32% of the general U.S. population.
Despite the growing need for support, many people who use Medicaid struggle to access care. This lack of support stems from Medicaid coverage barriers, inadequate information about available resources, reduced provider availability, and stigma surrounding mental health.
Nearly 160 million Americans live in areas with mental health professional shortages. Even if Medicaid beneficiaries live in an area with adequate mental health resources, they may not be able to receive care. For example, one Oregon-based study found that due to low reimbursement rates, more than half of mental health providers listed in Medicaid managed care plan directories did not actually see patients who use Medicaid.
Medicaid beneficiaries want—and need—more mental health support during their pregnancy, and the impetus falls on health plans to improve access to this essential care.
Lesson 2: Medicaid populations want to use virtual care
When it comes to the adoption of digital technology, the Medicaid population follows similar trends to those who are commercially insured. Studies estimate that Medicaid beneficiaries own smartphones at similar rates to their commercially-insured counterparts, with nearly 90% reporting that they have a smartphone.
The high levels of technology adoption among the Medicaid population represent a powerful opportunity for health plans to use digital tools to improve care. Most Medicaid beneficiaries report that they are interested in using technology for a variety of health purposes, including connecting with a live health coach through an app or working with a virtual assistant to identify symptoms.
At Maven, we see this trend play out: pregnant members who use Medicaid have 20+ touch points per month in the Maven platform*.
Lesson 3: Both hyper-localization and scale are needed to meet the needs of Medicaid
When building out maternity care for Medicaid beneficiaries, both a hyper-localized and scalable approach is necessary to maximize impact.
Each state is unique, with different laws and regulations surrounding their Medicaid services. Plans need to plug into community-based organizations (CBOs) to build trust among people who use Medicaid and drive better outcomes. CBOs are expert resources working closely with underserved communities, providing health plans with localized expertise and helping to deliver efficient, culturally-sensitive, and high-quality care.
Maven localizes its services to Medicaid members through Care Advocates, who are educated in state-by-state Medicaid dynamics and work with every member to help them navigate to in-person care and resources.
For example, almost 20% of Medicaid members on Maven report that they struggle with food insecurity*, compared to less than 2% of Commercial members on Maven. Maven’s Care Advocates work with trusted organizations in the member’s community to help them get the resources they need to feed their families, like food vouchers.
The other necessary aspect driving impact on the Medicaid population is scale. Digital health can scale beyond local communities, allowing plans to better meet patient preferences and fill gaps in care. One area where this scale drives impact is through care matching, where people receive care from providers who share their same cultural background and lived experience. Care matching improves outcomes and increases treatment compliance, representing a powerful tool to better support Medicaid beneficiaries. By removing the boundaries of geography, digital health widens the specialist pool, making it easier to connect beneficiaries with the right provider based on their unique needs.
Lesson 4: Digital solutions can support redetermination efforts
With Congress unwinding continuous enrollment in Medicaid in March 2023, states are now once again responsible for managing Medicaid redetermination efforts. Accurate demographic information and consistent member communication are two essential components of redetermination that state Medicaid agencies and plans often struggle with.
Digital solutions can help support these efforts by ensuring that Medicaid agencies have accurate demographic data about their members to simplify the redetermination process.
Digital health also aids in member communication; for instance, Care Advocates can share information with members on renewing their paperwork in a timely manner, and proactively support members through the redetermination process.
The way forward for Medicaid plans
As Medicaid plans look to apply these lessons to their maternity care programs, Maven is here to help. As the leading women’s and family health company, Maven is uniquely positioned to help plans scale their maternity support to better address the needs of the Medicaid population.
To learn more about how Maven can make a difference for your organization and your members, contact us today.
*Source: Maven Medicaid book of business, 2023
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