Community-Based Maternal Support Services: The Role of Doulas and Community Health Workers in Medicaid

Authors: Bakst C., Moore J., George K., and Shea K.
Year: 2020
State: NatDoc: National Document
Website link:
Publicly Available: Yes
Certification: CHW role scope of practice, Lessons learned from other states, Process and development, Specialty tracks and supervisor training
Evidence Generation: Documentation of how CHWs can work within care teams, Evidence-based interventions, General other, Results from pilots studies etc. that aren't published in formal literature, ROI and bundled payment successes/challenges, Surveys and assessment tools to define and develop workforce
Policy: General language around CHW WD, General other, Lessons learned from other states, MCO contract language and reimbursement models
Sustainable Financing: CMS and CDC engagement from a national level, Engaging state partners in general, General other, Including community-based CHWs, MCO or bundled payment reimbursement models, Evidence-based interventions, Results from pilots studies etc. that aren't published in formal literature, ROI and bundled payment successes/challenges
Workforce Development: CDC expand CHW work into SDOH, CHW training programs (not cert.), General other (including mention of “employment practices”), Training- Content modes delivery

In 2018, Medicaid covered approximately 43 percent of all births in the United States. As the largest single payer of maternity care, Medicaid plays a critical role in the health and wellbeing of pregnant individuals across the nation. As such, it is important to identify ways in which innovative models of maternity care and support services are being implemented in the Medicaid population. This report explores how community- based maternal support services provided by community-based doulas and maternity community health workers improve maternal health outcomes. It also highlights the results of a national environmental scan of organizations that are actively working toward eliminating maternal health disparities and building community connections through the community-based maternal support model. Finally, the report identifies common barriers to implementing this model and opportunities for Medicaid stakeholders to provide support and increased access to these services.

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