Michigan. MIHP covers all Medicaid-eligible pregnant women and infants until the age of 18 months for home visits.335 This program is part of partnerships with managed care organizations, and health plans are obligated to refer every pregnant woman covered under their plans to MIHP.336 MIHP has demonstrated positive effect on prenatal and postnatal care, including increased adequate prenatal care and increased timely postnatal care. It has also been shown to reduce infant deaths, both amongst Black populations and other populations of color.337 Additional Considerations
In the short-term, NC Medicaid should increase the role for CHWs in maternal health by integrating them into PMP. NC DHHS operates the Community Health Worker Initiative with the goal of “establish[ing] a sustainable infrastructure that acknowledges the value of CHWs, supports their professional identity, and integrates their role in the healthcare team”.338 NC DHHS should consider how it can leverage the Community Health Worker Initiative to deploy CHWs to maternal home visiting programs like PMP, similarly to how NC DHHS deployed over 400 CHWs to 55 counties.339
1.2 Postpartum Continuity of Care NC Medicaid should improve access to and continuity of care during the postpartum period. Implementation: • NC Medicaid should integrate postpartum care into well-child visits where the birthing mother is present. • NC Medicaid should utilize care coordinators for all Medicaid-eligible postpartum women to integrate them into medical homes. • NC Medicaid should specifically offer postpartum home visits to all Medicaideligible women. North Carolina Context
Continuity of care throughout pregnancy and postpartum is key to improving maternal and infant health outcomes.340 Acknowledging the importance of the postpartum period, North Carolina’s new budget includes a permanent expansion of pregnancy Medicaid to one year In the medium-term, NC DHHS should support postpartum. Despite this progress, ensuring funding increases to home visiting programs women, and specifically women of color, actually to expand their capacity to provide services through additional locations or staffing. Programs receive quality postpartum care should remain a top priority. like NFP and HFA operate on a combination of federal, state, and/or private funding. In North Carolina, postpartum visit attendance among Medicaid enrollees is troublingly In the longer-term, NC Medicaid should expand low. A study of six Atrium Health hospitals in eligibility for home visit case management to all Mecklenburg County in 2014-15 found that 90 pregnant and postpartum women on Medicaid. percent of mothers with commercial insurance, but only 50 percent of mothers with Medicaid, received a six-week postpartum checkup.341 Notably, a majority of the mothers insured by Medicaid were women of color—49 percent identified as Hispanic and 32 percent identified as non-Hispanic Black.342
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