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Page 10 – State Health Official

through multiple benefit categories, including, but not limited to, preventive services, services of licensed practitioners, clinic services, and freestanding birth center services. Similarly, while there is no distinct Medicaid state plan benefit called home visiting, states may cover many of the individual component services of home visiting programs through existing Medicaid coverage authorities.16 States can utilize value-based payment arrangements to incentivize the use of innovative maternal health care delivery models and improve health outcomes. CMS is available for technical assistance to states interested in adding these coverage options to their programs.

Maternity Core Set

To support states in their maternal, perinatal, and infant health-focused quality improvement efforts, CMS identified a core set of 11 measures for voluntary reporting17 by state Medicaid and CHIP agencies. This Maternity Core Set, which consists of seven measures from CMS’s Child Core Set and four measures from the Adult Core Set, is used by CMS to measure and evaluate progress toward improvement of maternal and infant health in Medicaid and CHIP. The areas of maternal health addressed in this set include: timeliness of prenatal care, postpartum care visits, contraceptive care, elective delivery, and low-risk cesarean section births. Two of these measures, Live Births Weighing Less than 2,500 Grams and Postpartum Care, are included in the State Health System Performance pillar of the Medicaid and CHIP Scorecard.18 Additionally, several measures on the Adult Core Set measure follow-up care for conditions that are associated with maternal morbidity and mortality (e.g., controlling high blood pressure and screening for depression and follow-up plan) and to assess ongoing well-woman care (e.g. cervical and breast cancer screening).19

CMS strongly encourages states to stratify these quality measures and other metrics of interest to states by race, ethnicity, geography, language and other indicators in order to identify disparities in access to care and health outcomes and to develop targeted initiatives to improve maternal health equity.

Maternal and Infant Health Initiative

To improve access to and quality of care for pregnant and postpartum beneficiaries and their infants, CMS launched the Maternal and Infant Health Initiative (MIHI) in July 2014.20 Today, the MIHI is focused on driving improvement in three areas, each of which is associated with one or more Maternity Core Set measures:

1) Increase the use and quality of postpartum care visits; 2) Increase the use and quality of well-child visits; and

16 https://www.medicaid.gov/federal-policy-guidance/downloads/cib-03-02-16.pdf 17 Pursuant to Section 50102(b) of the Bipartisan Budget Act, reporting on the seven measures that are part of the Child Core Set will become mandatory for states beginning in 2024. Additionally, the behavioral health measures on the Adult Core Set will also become mandatory in 2024, pursuant to Section 5001 of the SUPPORT Act. 18 https://www medicaid.gov/state-overviews/scorecard/state-health-system-performance/index html 19 https://www medicaid.gov/medicaid/quality-of-care/downloads/2021-maternity-core-set.pdf 20 https://www medicaid.gov/medicaid/quality-of-care/improvement-initiatives/maternal-infant-health-care-quality/index html The contents of this document do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract. This document is intended only to provide clarity to the public regarding existing requirements under the law.