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TMaH

Transforming Maternal Health Model

The Transforming Maternal Health (TMaH) Model supports participating state Medicaid agencies (SMAs) in the development of a whole-person approach to pregnancy, childbirth, and postpartum care. By addressing the physical, mental health, and social needs experienced during pregnancy, the model aims to improve outcomes and experiences for mothers and babies, while also reducing overall program expenditures.

Active since 2025-01-01

Innovation

Integrates behavioral health, social drivers of health, and continuity of care in the postpartum period, including building a bridge between clinical and community-based care.

The Problem

The United States has one of the highest maternal mortality rates among high-income countries which disproportionately impacts Medicaid populations.

The Solution

The model supports state Medicaid agencies and holds them accountable to implement evidence-based strategies for expanding access to maternal care, while also integrating behavioral health, social drivers of health, and continuity of care in the postpartum period, including building a bridge between clinical and community-based care.

Expected Outcomes

The model aims to improve maternal and infant health outcomes, such as reduce rates of low-risk cesarean section (c-section), severe maternal morbidity (SMM), and incidence of low birthweight infants and improve overall care experiences for pregnant women.

Strategy

The model aligns with CMMI strategy to promote preventive care by increasing engagement in prenatal and post-partum care, expanding the perinatal health care team, and screening for and managing co-morbidities, as well as empowering patients by increasing their access to health information through technology and data, telehealth, and home monitoring.

Model Goals

  • Improve maternal and infant health outcomes
  • Reduce rates of low-risk cesarean section (c-section)
  • Reduce severe maternal morbidity (SMM)
  • Reduce incidence of low birthweight infants
  • Improve overall care experiences for pregnant women
  • Reduce overall program expenditures

Patient Eligibility

Medicaid populations experiencing pregnancy, childbirth, and the postpartum period.

  • Medicaid beneficiary
  • Pregnant or postpartum

Provider Eligibility

Participating state Medicaid agencies (SMAs).

  • State Medicaid agency (SMA)

Care Categories

Maternal Health

Pregnancy careChildbirthPostpartum care

CMS Benchmarks & Thresholds

operational

Model End Year2,034
Model Duration10
Model Start Year2,025
Number of Participants15

Performance Metrics

Low-risk cesarean section (c-section) rate

Reduction in rates of low-risk c-sections

Severe maternal morbidity (SMM)

Reduction in severe maternal morbidity

Low birthweight infants

Reduction in incidence of low birthweight infants

Detailed CMS benchmarks are being added for this model.

Operational Friction Summary

Where operational friction is highest for this model.

Patient Attribution & ActivationHigh Friction

Early identification of pregnancy in Medicaid populations is critical to deploy behavioral health and social drivers of health (SDOH) interventions that prevent low birthweight and severe maternal morbidity.

Longitudinal Data Visibility & ReportingHigh Friction

TMaH requires integrating clinical care with community-based services (e.g., doulas, midwives) and behavioral health, which often operate on disparate or non-existent EHR platforms.

Episode Risk Management & Financial Window ControlHigh Friction

Financial accountability in TMaH is tied to specific clinical outcomes (c-section rates, SMM) that are heavily influenced by decisions made during the acute labor and delivery window.

Incentive Alignment Across EntitiesHigh Friction

Success in TMaH relies on shifting care toward high-value, community-based models (midwifery, doula care), which historically compete with or are siloed from traditional hospital-based OB practices.

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