Payers Leverage Technology to Boost Maternal Health Outcomes

Payers are implementing new programs that capitalize on telehealth and partnerships with technology companies to better engage pregnant members and improve maternal health outcomes.

There has been an ongoing effort to address the maternal mortality crisis from both the government and the healthcare industry. However recent data from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics showed an 18 percent increase in maternal mortality in the US between 2019 and 2020.

As overall maternal outcomes worsen, racial health disparities continue to expand for Black and indigenous birthing people.

AHIP encouraged payers to integrate health technologies like telehealth into perinatal and maternal health to close access gaps to obstetric care in rural and underserved communities.

Perinatal telehealth interventions to improve outcomes can include videoconferences to replace or supplement in-person visits and enable consultation with specialists remotely, AHIP mentioned.

In the postpartum period, telehealth and other tools can be implemented to drive earlier postpartum follow-up visits and provide access to lactation consultants (tele-lactation).

Within the last year, Capital District Physicians' Health Plan and Harvard Pilgrim Health Care partnered with digital family health platform Ovia to help members navigate fertility, pregnancy, and early parenting.

Through this partnership, members will gain access to three mobile apps - Ovia Fertility, Ovia Pregnancy, and Ovia Parenting in an effort to reduce maternity costs and improve maternal outcomes such as lowering c-section rates, preterm delivery, and neonatal intensive care unit (NICU) stays.

Healthcare provider Independence Blue Cross’ Baby BluePrints program uses predictive modeling to determine how social determinants of health impact high-risk maternity patients. This work includes behavioral health screenings and assessments for factors including transportation, food security, and financial wellbeing.

Additionally, the program provides personalized resources to support members through pregnancy and post-partum care, leveraging patient engagement technology.

In March 2022, Blue Cross and Blue Shield of North Carolina (BCBSNC) started piloting a new maternity health AI model with its CarePath staff. This model uses emergency room utilization data during pregnancy to predict high-risk status. Now, BCBSNC is piloting the use of CDC’s Social Vulnerability Index (SVI) data to identify members who face challenges and who may be at risk of poor maternity outcomes.

Even though these technologies have the potential to ameliorate poor health outcomes, they could also raise disparities due to limited broadband or technology access.

“The use of telehealth and other technologies can increase disparities if their use is not thoroughly supported at the local, state, and federal level,” AHIP wrote in a press release. “Unstable or unaffordable access to broadband internet in some areas and the costs of communication devices can limit who can use these tools.”

Currently, few state Medicaid programs reimburse beneficiaries for telehealth services delivered to the patient in their home, limiting access for pregnant women.

At the start of the pandemic, the Centers for Medicare and Medicaid Services (CMS) granted states flexibility in telehealth programs under Medicaid. However, as temporary, pandemic-related public payer policies will expire.