Medicaid: Keeping Moms Healthy
By: Patrick Conway, M.D., Principal Deputy Administrator and CMS Chief Medical Officer and Vikki Wachino CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services (CMCS)
More than any other health insurance program, Medicaid plays a key role in promoting the health of new mothers. Covering roughly half of births, Medicaid is there for new moms and their babies right from the beginning. We’re excited to showcase two ways that Medicaid can help get new moms and their babies off to the best possible start.
Help at the Right Time
Welcoming a new baby into the family is typically a time of great joy. But for some mothers it can also be a time in which they experience the “baby blues,” or in more serious cases, postpartum depression. Maybe you or someone you know has struggled with feelings of depression, detachment or even fear after the birth of a child.
Maternal depression presents a significant early risk to proper child development, the mother-infant bond, and the family. Children raised by clinically depressed mothers may perform lower on cognitive, emotional and behavioral assessments than children of non-depressed caregivers, and are at risk for later mental health problems, social adjustment difficulties, and difficulties in school. That’s why screening for and treating maternal depression is such an important tool to help prevent these adverse effects on a child’s development.
This is where Medicaid can help. Medicaid covers maternal depression screenings for mothers of Medicaid-eligible children performed by a pediatrician, often as part of a well-child exam, helping moms and their babies get the care they need.
For example, Colorado, Illinois, North Dakota and Virginia are helping moms get these screenings by making it easier for providers, including pediatricians, to have the tools they need to conduct the screenings and bill Medicaid appropriately. Making sure pediatricians have the tools they need is key, as they not only play a pivotal role in assessing the health and wellbeing of both moms and their babies, but may also be the health care practitioner most often interacting with a new mother.
Screenings represent a valuable opportunity for timely identification of issues; they are also a pathway to effective treatment. Based on the results of her screening, the pediatrician can refer the mother to diagnostic and treatment services as part of her needed follow-up care, which Medicaid will cover if she’s eligible for and enrolled in the program.
Today’s Informational Bulletin describes how Medicaid can pay for services that are for the direct benefit of the child, but that may also include the mother.
Helping Families with Home Visitation
Home visiting programs are another way to get new moms and babies off to a great start in life. Home visiting programs do much more than simply promote health – they encourage positive parenting, promote school readiness, and prevent child abuse and neglect.
While not part of today’s Informational Bulletin, combining maternal depression screenings and treatment with home visitation programs is a winning combination. That’s why we wanted to highlight the Federal Home Visiting Program guidance we released in March in partnership with the Health Resources and Services Administration (HRSA).
This guidance includes examples of how states can design a home visitation program for pregnant women and families with young children, and walks through the typical components of such programs, such as developmental and social screenings for both moms and their babies, case management and referrals to needed treatments, and the provision of activities including family support and counseling services and parent/caregiver skills training. These home visitation programs keep moms and their babies at the heart of delivering effective, efficient and quality care.
In addition, our work with HRSA closely aligns with another way Medicaid supports the health of moms and their babies: Medicaid’s Maternal and Infant Health Initiative. This initiative focuses on increasing the rate and content of postpartum visits, as well as increasing the rate of intended pregnancies through the use of effective contraception. Last month, we released an Informational Bulletin describing how states can knock down barriers for women, including new moms, in accessing effective contraception, which has been shown to help reduce the risk of low-weight and/or premature birth while helping a woman’s physical and emotional well-being.
Together, these guidance documents provide information that we hope will be helpful to states, providers, advocates and beneficiaries in understanding the resources that are available to give families the best start possible.