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Quick Facts About

Medicaid & Pregnancy

Coverage

41% of all births in the United States are financed by Medicaid. Among Black and Hispanic mothers, the numbers are even higher: 64.0% and 58.1% of deliveries, respectively.

Education

The majority of birthing women with less than a college degree are on Medicaid.

Geography

Medicaid enrollees are more likely to live in rural areas than the average American.

Access

Nearly 900,000 women nationwide fall into the coverage gap in states that have not implemented the Medicaid postpartum expansion.

Spotlight on

Barriers of Access

Medicaid enrollees are less likely to receive prenatal care in the first trimester of pregnancy and adequate prenatal care overall than those who are privately insured.

Source

Technology
Health Literacy
Transportation
Close Open Technology

Contrary to popular expectation, disparities among the Medicaid population do not extend to technology.

Medicaid enrollees use technology at only slightly lower rates than adults with exchange coverage, and express equal interest in using technology for their health. Digital health is a viable option for supporting Medicaid enrollees. 

Source

 
 
Medicaid
Private Insurance

Smartphone Ownership

86%

94%

Tablet Ownership

69%

79%

Wearable Devices

29%

39%
Close Open Health Literacy

Medicaid enrollees are more likely to be at basic levels of health literacy or below.

Health literacy is one of the greatest barriers to care, particularly preventative care — much higher than technology ownership or geographic access. Communicating information at a simplified reading level is critical for improving access to and engagement with care.

Source

 
Health Literacy - Medicaid
Close Open Transportation

Lack of transportation is a major barrier of access to care and to non-clinical resources such as food support.

Transportation insecurity is experienced disproportionately by women of reproductive age with low incomes and a low degree of formal education, who are more likely to be enrolled in Medicaid.

Lack of access results in lower utilization of prenatal care and higher costs associated with delivery.

Sources: BJOG, CDC

 
Transportation - Medicaid
Spotlight on

Reimbursement

Health Equity - Group of Diverse Women Illustration

Medicaid coverage for remote patient monitoring devices and services is rapidly expanding but not universal. Currently, Medicaid covers RPM services in slightly more than half of states.

Starting in January of 2024, the Centers for Medicare and Medicaid Services (CMS) have ruled that Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) can now bill for RPM under new global coding.

CMS introduced the Transforming Maternal Health (TMaH) Model, designed to focus exclusively on people enrolled in Medicaid and Children's Health Insurance Program (CHIP). TMaH is a state-based model, in which state Medicaid agencies serve as model awardees. Along with state Medicaid agencies, Managed Care Organizations (MCOs), Perinatal Quality Collaboratives, hospitals, birth centers, health centers and rural health clinics, maternity care providers and community-based organizations are critical collaborators to model success.

Medicaid Considerations for

Payers & Pregnant Members

Identify Risk Earlier

Many risk-related benefits are available to patients through their health plan, but often are underutilized because the health plan is unaware of the risk. By deploying mobile risk assessments for behavioral, social, and health-related challenges to members, payers can identify needs in real time and engage members with the appropriate available resource to address their risk, decreasing hospitalization and ER utilization.

Activate Provider-Sourced Insights

Babyscripts’ care collaboration model ensures that the health plan is receiving patient data as it’s being collected, including identification of pregnancy. Through Babyscripts, pregnancy is identified at an average of 14 weeks gestational age, with 25% of patients signed up as early as GA 7. It offers a pathway of communication between clinician and payer to deliver benefits and ensure that data is being acted on.

Reward Engagement

Babyscripts empowers member engagement through a consumer-friendly program with accessible wraparound education, visual and audio aids, push notifications and reminders for important care goals. Health plans can choose to incentivize members to complete milestones with customizable rewards. 

Increase Resource Utilization

Frequently, the health plan is unaware of a member pregnancy until a claim is filed post-delivery, creating a missed opportunity for support. Medicaid enrollees are less likely to receive prenatal care in the first trimester of pregnancy and adequate prenatal care overall than those who are privately insured, which is tied to negative outcomes such as increased likelihood of C-section and preterm birth. Earlier pregnancy identification allows payers to effectively surface available resources to eligible members and increase engagement with benefits.

Deliver Equitable Solutions

Remote patient monitoring provides a way to equalize care delivery through objective, data-driven solutions. For many reasons, from lack of transportation or time off from work to distrust of the healthcare system, Medicaid recipients are more likely to delay or forego care than patients who receive health insurance through their employer. Remote patient monitoring can reach those members and improve their quality of care, strengthening trust in the health system. Babyscripts’ trigger alert system is not subject to biases of human interpretation, ensuring an equitable response to risk situations.

Medicaid Blog Posts

Virtual Care Resource Center

CMS TMaH

CMS introduces new Transforming Maternal Health (TMaH) model to support equity and access for Medicaid births

CMS announces a new model for maternal health care focused on Medicaid beneficiaries and CHIP that will support access to care and health equity.

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Expand Medicaid 2

5 Reasons We Need to Expand Medicaid For Postpartum

Multiple states have implemented Medicaid expansion for new moms up through one year postpartum and seen positive real-time and downstream effects.

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Medicaid

Serving the Medicaid Population: Barriers, Solutions, and the Role of Digital

The Medicaid population faces unique barriers to care that should inform product development for digital health solutions seeking to address them.

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Untitled design (4)-3

Medicaid Postpartum Expansion: Implications and the Critical Role of Digital Health

The critical role digital health will play in maternal health outcomes post new Medicaid postpartum expansion.

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Learn more about Babyscripts for Medicaid

Medicaid plays a key role in addressing concerns about rising pregnancy-related mortality and morbidity and significant racial and ethnic disparities in maternal outcomes. Schedule a demo to learn more about how Babyscripts works with payers and care teams serving Medicaid populations.