State Medicaid Quality Measurement Activities for Women’s Health

*Maps and Chart updated as of November 3, 2017*

State Medicaid agencies provide a variety of health services to women that promote overall health and well-being and support improved birth outcomes, such as reduction in infant mortality rates. States have the option of implementing performance measurement, incentives or improvement projects, including as part of broad health system transformation, to promote women’s preventive care, chronic disease management, and perinatal care. This series of maps and accompanying chart illustrate state-specific Medicaid measures, performance improvement projects, and incentives promoting women’s health services, such as those recommended by the Health Resources and Services Administration (see more information for details). The series reflects: managed or accountable care performance improvement projects; managed care performance measures; metrics or incentives in statewide Medicaid system transformation (e.g., patient-centered medical home, accountable care initiative); other financial incentives for providers, including pay for performance; and patient incentives. Measures, projects and incentives fall into seven general categories: behavioral health, chronic disease, delivery and postpartum care, general health, prenatal care, reproductive health, and substance use.

Acknowledgement:
This chart is a joint publication of the National Academy for State Health Policy (NASHP) and the National Institute for Children’s Health Quality (NICHQ). This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) (under grant # UF3MC26524, Providing Support for the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, $2,918,909, no NGO sources).

More Information

   •  The most common women’s health measures across states are:  Postpartum Care (46 states), Timeliness of Prenatal Care/Early Prenatal Care Entry (39 states), STI
Screening/Treatment (39 states), and Frequency of Ongoing Prenatal Care (33 states).
   •  46 states plus the District of Columbia have an activity in at least one of the 15 highlighted measures.
   •  Over 35% of states have implemented at least one improvement project or incentive within managed care (19 states).
   •  Performance improvement projects are the most common strategy used by state Medicaid agencies to improve quality of care.

The American Congress of Obstetricians and Gynecologists, in partnership with the American Academy of Family Physicians, the American College of Physicians, and the National Association of Nurse Practitioners in Women’s Health, is providing recommendations to update the Health Services and Resources Administration-supported Women’s Preventive Services Guidelines which help clinicians determine the screenings and other health services to routinely offer to patients. The Guidelines include the following services: well woman visits; gestational diabetes screening; sexually transmitted infection (STI) counseling; human immunodeficiency virus (HIV) screening; contraceptive methods and counseling; breastfeeding support, supplies, and counseling; and screening and counseling for interpersonal and domestic violence.  For additional information, see the Women’s Preventive Services Initiative website.

We hope these maps and downloadable 50-state chart will be valuable resources to states as they continue to look at strategies to improve perinatal outcomes through women’s health services. Know of something we should add to this compilation? Does your state have a new incentive, measure, or improvement project in place? Your feedback is central to our ongoing, real-time analytical process, so please email aagrawal@nashp.org with any feedback, additions, or edits.

The information for these resources was drawn from a number of sources include state websites and reports, and federal data. NASHP made efforts to confirm all information directly with states. The Health Resources and Services Administration supports this work as a part of the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality.

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