Comprehensive, Continuous Primary Care: The Key to Transforming Maternal Health

According to the Centers for Disease Control and Prevention, 84 percent of pregnancy-related deaths are preventable. Yet, the number of women dying in childbirth or within a year of giving birth has only increased, with 658 deaths in 2018 and a staggering 1,205 deaths in 2021. While some of these deaths can be attributed to the COVID-19 pandemic, chronic diseases, such as mental health and heart conditions, as well as excessive bleeding were identified as the leading causes of pregnancy-related deaths. Moreover, maternal mortality rates disproportionately affect vulnerable populations, with Black women being 3-to-4 times more likely to die from preventable pregnancy-related complications than non-Hispanic white people.

To address these problems, the Centers for Medicare and Medicaid Services (CMS) is testing a new model called the Transforming Maternal Health (TMaH) Model. Aiming to address the physical, mental and social needs experienced during pregnancy, the TMaH model will support state Medicaid agencies (SMAs) in the development of a whole-person approach to pregnancy, childbirth and postpartum care. The model will provide states with funding and technical support to develop value-based alternative payment models to expand the maternal care team, establish quality protocols specific to maternal health and encourage collaboration between patients and care teams when developing maternal care plans.

PCC applauds CMS for taking these steps to implement a whole-person approach to maternal health, and we encourage states and CMS to make primary care an integral part of the solution. Patient-centered, accessible and team-based are only a few of the Shared Principles of Primary Care that CMS can encourage states to employ when building out maternal care teams and developing care plans with patients. In terms of improving the quality of maternal health care, an individual’s health prior to pregnancy influences outcomes and a continuous, long-term relationship with a usual source of primary care is.

For these reasons, CMS and states that participate in this model should begin their efforts to improve maternal health by improving most patients’ first encounter with the health care system: primary care. Whole-person primary care has proven effective in preventing and managing the very chronic conditions that have been linked to risk before and after pregnancy. So, it’s critical that primary care has all it needs to support maternal health and save lives.