Posted: 8/23/2022
Program awarded for innovation in improving equity in postpartum care
Parkland Health’s extending Maternal Care After Pregnancy (eMCAP) program was nationally recognized by winning the Department of Health and Human Services (HHS) Racial Equity in Postpartum Care Challenge, a national competition launched by the HHS Office on Women’s Health and the Centers for Medicare and Medicaid Services.
eMCAP, a Parkland-sponsored program in partnership with the University of Texas Southwestern Medical Center, was one of 25 winners of the Postpartum Care Challenge Phase 1 Award. The $1.8 million national competition was developed to identify effective programs that can address and improve equity of 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). In the United States, Medicaid covers 42% of all births, with two-thirds of births to Black and AI/AN women ensuring quality healthcare for delivery and the postpartum period.
According to the Centers for Disease Control (CDC), cardiovascular conditions were the leading cause of pregnancy-related deaths in the United States during 2014-2017. Other leading causes of death included infections and cardiomyopathy. In Texas, the CDC found that the maternal mortality rate is above the U.S. average, at 18.5 deaths per 100,000 live births. Importantly, more than one-half of pregnancy-related mortality in the U.S. occurs in the 12 months after birth, and about one-third occurs within the first year post-delivery. Pregnancy-related deaths are three to four times more common among Black and AI/AN women than among white women.
Using data from the Community Health Needs Assessment, Parkland’s health system developed the eMCAP program. Since its implementation on Oct. 1, 2020, the program has enrolled more than 2,977 women who have been recipients of health services before, during and up to one year after giving birth. Texas Medicaid only covers 60-days post-delivery care for eligible mothers. To address these gaps, the eMCAP program was designed using evidence-based approaches to target improved follow-up rates through virtual telehealth care, community health workers and home blood pressure cuffs.
“We have been able to provide a virtual nurse home visit to about 84% of these mothers to do an assessment and refer them for additional support and services. We also know about 70% of them immediately identified a need after delivery. Of those, 54% were healthcare needs such as a primary care follow-up. Around 21% were behavior health/substance abuse needs, 14% were transportation needs, and 11% were dental and eye care needs,” said Marjorie Quint-Bouzid, MPA, RN, NEA, BC, Parkland’s Senior Vice President for Women & Infant’s Specialty Health.
“We are challenging the traditional, fragmented approach to healthcare for patients after birth,” said David B. Nelson, MD, Chief of Obstetrics at Parkland Health and Associate Professor in Maternal-Fetal Medicine and Dedman Family Scholar in Clinical Care at UT Southwestern Medical Center. “By providing healthcare services and social support to patients in their community, rather than having to come to the hospital, the eMCAP program is demonstrating improvement in both attendance and quality of postpartum care for women living in underserved areas,” added Dr. Nelson.
The eMCAP program also helps women navigate systems of care to get those needs met, including scheduling appointments, maintaining insurance coverage, obtaining infant care supplies and helping with transportation, Quint-Bouzid noted.
For more information about Parkland, visit www.parklandhealth.org. To donate in support of the eMCAP program, please go to Areas of Need - Extending Maternal Care After Pregnancy - Parkland Foundation at www.istandforparkland.org/.