Maternal telehealth emerges as a priority for states via new federal program
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Under the Rural Health Transformation Program, several states have dedicated a share of their funds to innovating and modernizing maternal health care delivery.
Across the U.S., an estimated 2.3 million women and girls between the ages 15 and 44 live in maternity health care deserts, where labor and delivery services are limited or unavailable. States have long tried to address such gaps in care for new parents and babies, and the recently announced Rural Health Transformation Program could give leaders an extra push to do so, experts say.
The federal government announced it would be granting $50 billion over five years to all states last month, with states receiving $10 billion a year through 2030 to enhance health care delivery in rural communities. The modernization of health care services is one priority area for states, which can help innovate how new parents connect with crucial pre- and post-natal care, said Veronnica Thompson, director of maternal and family health at the National Academy for State Health Policy.
“We're seeing across the board in the health care system, that rural areas in particular are facing provider shortages, specifically in a specialty area such as obstetrics,” she said.
Between 2006 and 2020, more than 400 maternity wards closed across the nation, disproportionately and significantly impacting the labor and delivery resources available in rural counties. Fewer places for women to safely give birth or a smaller number of specialty providers to deliver babies puts health outcomes at a higher risk, as pregnant people have to wait or travel longer distances to receive the necessary care they need, Thompson explained.
The Rural Health Transformation Program is one way states are continuing their efforts to improve maternal health care. At least 20 states, for instance, have identified maternal health in their preliminary plans for funding allocations, according to the Centers for Medicare and Medicaid Services.
Several states are planning to boost telehealth services for maternal health care, which can help improve the continuity and coordination of care for women throughout their pregnancies, Thompson said.
Arizona, for example, is investing $25 million into expanding the availability of obstetrics consultations via telehealth at the regional level, as well as psychiatric services to address prenatal and postpartum care gaps. The state will also deploy mobile units with telehealth capabilities to better serve rural communities.
California will undertake a similar effort by allocating a part of its total request of $1 billion in funds to invest in regional hub-and-spoke networks that enable remote patient monitoring for prenatal care, as well as electronic consult services for perinatal psychiatric care.
Telehealth is also a priority for New Mexico, which is allocating $393 million over five years to expand networks like e-consultations, remote patient monitoring and virtual health care platforms at facilities focusing on maternal health, chronic disease and behavioral health care across the state.
New Mexico also plans to address the rural provider gap by supporting mentoring and supervision for training clinicians through tele-based services. Such efforts can help retain and expand the rural health care workforce by allowing more individuals to practice in remote areas, Thompson said.
The focus on improving maternal health outcomes across the U.S. is not a new trend, but has ramped up over the last decade as officials grappled with alarming infant and maternal mortality rates in recent years, said Karen VanLandeghem, senior director of children and family health at NASHP.
“States have, in the last decade, designed and implemented a variety of policy strategies to try to improve maternal outcomes,” she said.
Nearly all 50 states have, for instance, expanded postpartum Medicaid coverage for beneficiaries or have expanded access to prenatal services like doulas, though the continuation of such services are uncertain as states face major cuts to their health programs from the federal government.
“While the rural health transformation funding is not intended to offset all projected losses in funding for rural health systems, we do think that these new resources can offer really important opportunities to rethink and transform the way care is delivered in rural communities with an eye towards sustainability and more efficient models of care,” VanLandeghem said.