HHS Challenge Addresses Racial Equity in Postpartum Care
Digital apps for patients and providers to track and monitor symptoms and that enhance care coordination were among the winners of the second phase of the U.S. Department of Health and Human Services’ $1.8 million Racial Equity in Postpartum Care Challenge.
The national competition was developed to improve equity in postpartum care for Black or African American and American Indian/Alaska Native (AI/AN) women enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).
“Health equity and access to care are top priorities for my office and are foundational to addressing maternal health disparities in our country,” said Assistant Secretary for Health Admiral Rachel Levine, in a statement.
Medicaid covers more than 40 percent of all births in the United States. Roughly 64 percent of those are Black women. In addition, there are significant and persistent racial and ethnic disparities in pregnancy-related deaths, which are three to four times more common among Black and AI/AN women than among White women. Black women also have the highest risk for progression from gestational diabetes, or diabetes during pregnancy, to Type II diabetes after birth; higher rates of self-reported depression; and Black women 20-44 have more than twice the hypertension prevalence of other racial and ethnic groups.
More than one-half of pregnancy-related mortality occurs in the 12-month postpartum period, which is why 43 states, the District of Columbia, and the U.S. Virgin Islands have extended Medicaid coverage for 12 months after pregnancy. Postpartum care provides necessary follow-up care for conditions associated with morbidity and mortality during and after pregnancy.
In phase one, winners identified effective programs that could successfully increase access to, attendance at, and quality of care for postpartum visits for Black and AI/AN beneficiaries enrolled in Medicaid or CHIP. Final phase winners are those who successfully replicated and/or expanded their phase one programs addressing equity during the postpartum period with an emphasis on follow-up care for diabetes, postpartum depression and/or anxiety, hypertension, and/or substance use disorders. The prizes will allow these programs to continue to serve Black or African American and AI/AN communities and provide critical postpartum health services.
“Equity in postpartum care is critical to addressing the significant and persistent racial and ethnic disparities in pregnancy-related illness and deaths,” said Dorothy Fink, M.D., deputy assistant secretary for Women’s Health and Director of the Office on Women’s Health, in a statement. “Recognizing innovative programs demonstrating successful outcomes enables sustainable change in these communities.”
Phase two winners include:
Benten Technologies – Philadelphia, PA
Program/Focus: MommaConnect mHealth App
MommaConnect, a digital healthcare application that provides remote access to psychotherapy for pregnant and postpartum women, improved symptoms of postpartum depression and decreased the average number of mothers in the program who reported depressive symptoms. The program offers evidence-based treatment programs to address various mental health needs, including postpartum depression, anxiety, and impaired maternal-to-infant interactions.
Center for Women’s Mental Health (Johns Hopkins) – Baltimore, Maryland
Program/Focus: The Integrated Perinatal Clinic
The Integrated Perinatal Clinic, a program that provides mental health services to postpartum women, expanded mental health protocols by providing mental health screening for pregnant and postpartum women, which decreased the number of unplanned hospital visits and improved health outcomes for patients who received treatment.
Mammha at Children's National Medical Center – Washington, DC
Program/Focus: Technology/Mobile
App
Mammha, a mobile and web-based app program that provides on-site and remote mental health screening, psychoeducation, referrals, and brief care coordination for at-risk mothers in partnership with care teams, increased the number and identification of Perinatal Mood and Anxiety Disorder (PMAD) screenings, increased referrals of at-risk mothers, and expanded the program to include mental health screenings for parents with babies in the neonatal intensive care unit (NICU).
Emagine Solutions Technology, LLC – Tucson, AZ
Program/Focus: The Journey Pregnancy and the Journey Clinic
The Journey Pregnancy and the Journey Clinic, real-time digital apps for patients and providers to track and monitor symptoms such as preeclampsia and diabetes, doubled use by Black/African American women and expanded American Indian/ Alaska Native women’s use by seven times. This program uses a machine learning model to encourage and increase communication between patients and providers, increase early detection of symptoms, and contribute to the early initiation of care to decrease morbidity and mortality.
Healthy Hearts Plus II – Richmond, VA
Program/Focus: Mommies, Bellies, Babies, and Daddies Care Coordination; Technologies for Outreach
Mommies, Bellies, Babies, and Daddies Care Coordination, a program that offers a suite of digital solutions to improve postpartum care and the coordination of services for postpartum Black/ African American women, has expanded digital services, education, and support platforms for families, doubling its capacity from phase one. The program uses data to identify target populations with increased need and provides comprehensive, evidence-based care to underserved populations based on a population-based assessment tool.
Heart Safe Motherhood Institution: Penn Medicine – Philadelphia, PA
Program/Focus: Heart Safe Motherhood (HSM), Way – Text Message Based Platform to Improve Blood Pressure Control
Heart Safe Motherhood, a program that uses technology to provide patients with automated reminders to check their blood pressure and alerts patients and providers if numbers are high, expanded use across multiple Philadelphia hospitals and plans to expand across multiple states.
Northwell Health Inc. – Westchester County, NY
Program/Focus: Maternal Health Outcomes and Morbidity Collaborative (MOMS)
The Maternal Health Outcomes and Morbidity Collaborative, a program that uses comprehensive care coordination, patient-centered approaches, and technology to identify risk factors and connect prenatal and postpartum patients to medical, behavioral health, and social supports, tripled enrollment and increased referrals to several medical specialties, including lactation support, WIC, behavioral health, gastroenterology, cardiology, endocrinology, and home health.
The Maternal Health Program: CyncHealth, PointClickCare, and Innsena – Omaha, NE and Iowa
Program/Focus: The Maternal Health Program Provides Digital Solutions to Care
The Maternal Health Program, which uses technology and collaboration to identify, track, and connect providers to health data, including indicators for several mental and physical medical conditions, expanded services from Omaha to sites across the state and increased the number of women they reached. Pregnant and postpartum care teams in hospitals, medical homes, and other care facilities receive real-time data and alerts when health indicators are out of range.
Woman’s Hospital – Baton Rouge, LA
Program/Focus: Diabetes Navigation System (DNS)
The Diabetes Navigation System, a program that provides comprehensive care for prenatal and postpartum patients with diabetes, expanded to provide in and outpatient perinatal care for almost twice the number of women. As a result of program implementation and sustainability, patients had triple the DNS diabetes care compliance rate compared to those not in the program. As a result, patients enrolled had three times the rate of diabetes care compliance to diabetes care.
Yale School of Medicine Community Health Care Van; Mother Infant Program (MIP) – New Haven, CT
Program/Focus: Mobile Van (Community Healthcare Van- CHCV), CHCV Mother Infant Program, Curbside Postpartum Care
Curbside Postpartum Care, a program that uses mobile support and evidence-based data to address priority health needs, including behavioral health services, screening for postpartum depression and substance use disorder, and connecting patients to treatment and care, increased program accessibility and doubled the number of referrals made to behavioral health and healthcare services for women at risk for postpartum depression or hypertension.
