News Center for Advancing Health Services, Policy & Economics Research

Center reports recommendations for maternal health policy changes in Missouri

Maternal and infant health is a critical problem for Missouri and the rest of the United States. While many other health metrics have improved in the U.S. in recent decades, outcomes for mothers and infants have worsened. Maternal mortality rates in Missouri and nationally have been rising in recent years; Missouri’s rate exceeds the national average. Furthermore, Black women in Missouri are more than three times as likely as White women to die from pregnancy-related causes.

Center for Health Economics & Policy white paper

The Center for Health Economics and Policy at the Institute for Public Health has published a new white paper containing recommendations for advancing quality maternal health care and pregnancy outcomes in Missouri. The recommendations stem from the center’s recent series of convenings, “Transforming Healthcare in Missouri Part V: Policies & Partnerships to Advance Pregnancy Outcomes”. Participants included managed care organization representatives, clinicians, program leaders, advocates, researchers, Medicaid agency staff, and other stakeholders in Missouri pregnancy care.  Experts such as Director of the Division of Clinical Research, Obstetrics & Gynecology at Washington University School of Medicine, Ebony Boyce Carter, MD, presented on successful innovative models for maternal healthcare delivery and payment; and panelists from other states spoke on such topics as freestanding birth centers, pregnancy medical homes, provider pregnancy management programs, and community care hubs.

As a high-risk obstetrician caring for predominately Black women in St. Louis, I can tell you that patients are terrified. Black patients will drive hours to see me as a Black physician. They are terrified that pregnancy—a time that should be filled with joy and promise—will bring personal peril and death for them or their baby. These statistics are well publicized in the popular press. Black patients are seeing and living the story behind these statistics every day and they are justifiably scared.

Ebony Boyce Carter, MD, MPH

Participants were divided into small groups and discussed innovative ways of delivering and paying for pregnancy-related care, with an emphasis on Medicaid. Potential solutions were divided into three categories:

  • Coverage and Reimbursement
  • Care Delivery and Workforce
  • Data and Analytics

Organizers of the event series say that the program helped foster collaboration across varied groups, encouraging discussion about policies to advance pregnancy outcomes in order to identify areas of agreement regarding potential policy change.

The events were designed to be interactive and thought-provoking.  We know there are a lot of stakeholders in this area, many of whom are doing excellent work. We wanted to aggregate and synthesize these viewpoints with a policy lens. Often what it takes to make a great idea transformational at the population level is a policy change that makes it financially sustainable. Our events were intended to elicit such policy options.

Abigail Barker, PhD

The second event in the series was used to present the white paper to interested stakeholders and provide an opportunity for feedback on the recommendations. 

More information and the proposed recommendations are included in the center’s white paper. Learn more about our center’s work on Transforming Healthcare in Missouri.