• In The Trenches

    A Maternal Health Breakthrough and a PCF Model Update

    It’s good to be heard.

    physician examining pregnant woman

    A little more than two months ago, the Academy joined with 263 other national, state and local medical and health groups in urging CMS to swiftly approve pending Section 1115 demonstration projects aimed at extending postpartum Medicaid coverage in a number of states.

    On April 12, the first day of Black Maternal Health Week, the administration did exactly that, announcing the immediate approval of Illinois’ Section 1115 request — and advising other states to model their own efforts on the Prairie State’s. The move grants full Medicaid benefits to Illinois women for 12 months postpartum, a sixfold expansion from the previous 60-day allotment that’s in line with what evidence suggests should be the norm. It became effective the same day and is authorized through Dec. 31, 2025. We’re hopeful that further approvals are imminent.

    The February letter we co-signed reminded officials that ours is the only industrialized nation where maternal deaths are ticking upward. CDC data indicate that some 700 pregnancy-related deaths occur here each year, many of them illustrative of stark racial health inequities. “Black women are three times more likely to die from a pregnancy-related complication than non-Hispanic white women,” we said.

    This is why there is a Black Maternal Health Week, and why we endorsed the House resolution reaffirming it.

    It’s also why, the same week that the AAFP and its co-signatories wrote to CMS, we and the other frontline physician organizations in the Group of Six expressed strong support for the Black Maternal Health Momnibus Act of 2021. We believe this package of bills would make important strides in preventing maternal mortality and severe morbidity by addressing social determinants of health, investing in the medical workforce and funding care at the community level, among other measures.

    Across all U.S. populations, these needs are critical, and the Academy believes in striving to achieve birth equity. Family physicians are well positioned to address the issues at the heart of this crisis. You’re trained to deliver comprehensive services that include prenatal, perinatal and postpartum care.

    CMS is also making $12 million available over four years for the Rural Maternity and Obstetrics Management Strategies program. The idea is to test models that could “address unmet needs for their target population.”

    The Academy last year provided detailed information to CMS on maternal and infant care in rural communities. As I said, it’s good to be heard.

    Primary Cares First Webinar Tonight

    At 5 p.m. CT today, the AAFP, CMS staff, the AMA and the American College of Physicians are your co-hosts for a webinar overview of the Medicare Primary Care First model as applications for the program’s second cohort are being collected through May 21.

    The first group began participating in the PCF medical home payment model at the start of this year. The second gets underway in 2022, following an eligibility expansion. Practices in 26 regions can apply.

    At tonight’s webinar, which is being recorded for later viewing on demand, CMS staff will answer questions, and the AAFP and its co-hosts will explain how PCF works and help you determine if it’s right for your practice.

    Visit the Academy’s PCF page to learn more about the model.

    Your Turn

    Registration ends Friday for this year’s Family Medicine Advocacy Summit. Our virtual fly-in happens May 19 following a live training session the night before. We’ve also put together some short on-demand classes that will help you sharpen your storytelling and political engagement skills ahead of the big day. I encourage you to join your colleagues as AAFP members nationwide lobby their members of Congress on behalf of the specialty.

    One issue we’re focusing on for FMAS is Medicaid pay parity, and you can add your voice to that fight today by asking your representative to co-sponsor the Kids Access to Primary Care Act (H.R. 1025). This critical bill would help ensure that family physicians have the resources to care for Medicaid patients by increasing Medicaid payment rates for primary care services to at least Medicare rates.

    Stephanie Quinn is senior vice president of advocacy, practice advancement and policy.


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