Delivering Results: Exploring Variation in State Approaches to Maternal Health Policy, Implementation, Evaluation, and Outcomes

Session Submission Type: Roundtable

Abstract

With Medicaid financing approximately 40% of all births in the United States, maternal health policy is fundamentally driven at the state level. This decentralized structure creates a complex, highly variable landscape for both implementing and evaluating maternity care models. The current political climate presents a challenging paradox: an administrative focus on increasing national birth rates, juxtaposed with potential constraints on Medicaid funding. This tension demands a rigorous, evidence-based approach to identifying systemic cost-savings that can work across states and sustainably improve maternal and infant outcomes.

Historically, the research community has relied on universally tracked, easily accessible metrics to assess maternal health across states, frequently focusing on cesarean section rates as the primary measure of success. More concerningly, national data sets, such as T-MSIS have notably unreliable data quality related to maternal health. Researchers, unsurprisingly, struggle to capture the full spectrum of maternal health outcomes, systemic disparities, and the nuanced economic impacts of state-by-state policy variations.

This panel will bring together policymakers, maternal health researchers, and implementation consultants to bridge the gap between current challenges and efforts to improve outcomes on the ground. A central focus of the discussion will be exploring how different states are navigating Medicaid-funded maternal health policy as well as the effectiveness of national efforts on Maternal Health Policy through the Centers for Medicare Innovation (CMMI). We’ll explore topics including but not limited to expanded coverage for midwives and doulas, bundled payment systems, and group perinatal care. As states experiment with these coverage expansions to improve holistic care and health outcomes while simultaneously reducing costs, there is an urgent need for robust evaluation of their efficacy across diverse state regulatory and policy environments.

The session will center on a core question: How can the research community more effectively evaluate maternal health interventions through policy and implementation across varying state landscapes and inform improvement efforts? 

Anna Collier, MPA, (Managing consultant with the Lewin Group) will serve as the organizer and moderator for this discussion with policy, research, and implementation experts with decades of experience examining Medicaid maternal health policy and practice across states: Allyson Zucker, MPH, (Policy Maker at CMMI with prior experience as a Doula), Jeral Self, PhD, (Implementation Director with the Lewin Group), So O’Neil, MPH (Senior Director, Community Health, at Alterim), and Sarah Gordon, PhD, (Associate Professor in the Department of Health Law, Policy, and Management at the Boston University School of Public Health).PLEASE NOTE: Allyson Zucker has not made a Memberclicks profile because she is awaiting formal approval from CMMI leadership to participate & will create her profile once she is granted approval. We expect approval to be granted within the next month, but due to unexpected turnover within the agency, the approval process has been delayed. All other speakers have been added.

Policy Area

• Health Policy

Moderator

• Anna Collier, The Lewin Group

Organizer

• Anna Collier, The Lewin Group

Speakers

• Sarah Gordon, Boston University

• Jeral Patrece' Self, The Lewin Group

• Sasigant So O'Neil, Altarum Institute - Washington, DC

• Allyson Joy Zucker, Center for Medicare and Medicaid Innovation (CMMI)