New study details how Medicaid Accountable Care Organizations can improve maternal health care quality
Medicaid — the largest insurance program in the U.S. for maternity care — is uniquely positioned to shape maternal health. However, very few studies have investigated challenges health systems and providers face when implementing maternal health strategies.
A new study, published in The Milbank Quarterly, co-authored by Shannon Ogden, PhD, MPH, a postdoctoral research fellow at the Division of Research, helps fill this gap by examining the steps Massachusetts’ Medicaid Accountable Care Organizations (ACOs) took to improve maternal health care quality and equity. Odgen conducted the study as a graduate research assistant at Boston University School of Public Health. It is the first qualitative assessment of how Medicaid ACO programs implemented maternal health initiatives across multiple waiver periods.
Maternal mortality rates in the U.S. far outweigh those of other wealthy nations and continue to disproportionately affect Black and Hispanic populations. Medicaid ACOs — networks of health care providers and systems that are incentivized to improve health care and patient outcomes — have a unique opportunity to bolster maternal health care quality.
Ogden and her colleagues interviewed leaders, clinicians, and care coordinators for 6 of the 17 Medicaid ACOs in Massachusetts about the initiatives they introduced between 2018 and 2024. They found that the ACOs were able to improve the quality of patients’ maternal care by strategically incorporating new maternal metrics and initiatives mandated in their contracts, and by providing the necessary resources and infrastructure to meet these requirements.
“Our findings showed that metrics matter,” said Ogden. “Instituting maternal health-related metrics at an organizational level prompted ACOs and health care organizations to develop the programs needed to meet those metrics and track patients’ engagement. But we also learned that those metrics are only a starting point. There is still more work to be done to improve maternal health care quality and equity across Massachusetts’ Medicaid ACOs.”
Read the full story by the BU School of Public Health.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. KPDOR seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 720-plus staff, including 73 research and staff scientists, are working on nearly 630 epidemiological and health services research projects. For more information, visit divisionofresearch.kp.org.
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