Maternal Mortality

Maternal Health

The United States maternal mortality death rate in 2020 was more than three times the rate of most other high-income countries. The reasons behind this include inadequate prenatal care, rates of cesarean section, and socioeconomic inequalities. Additionally, mortality rates among pregnant and postpartum women increased from 2019 to 2020, with disproportionate fatalities faced by American Indian/Alaska Native and Black women.

• COVID-19 During Pregnancy: A study found that COVID-19 infection during pregnancy increased the risk of maternal death and severe outcomes among infants and pregnant women.
• Screening: Almost half of the pregnant people experiencing intimate partner violence are not screened. There are disparities in screening for alcohol consumption across education level, race, and ethnicity.
• Birth Rate: A new CDC report shared that the fertility rate rose from 2020 to 2021, the first increase in seven years. The report also shared that the teenage birth rate declined by 7% and there was an increase in preterm and low birthweight babies.

Resources & Initiatives:

• A recent article shares a variety of studies on maternal and neonatal risk-appropriate care and strategies to ensure facilities are capable of meeting their health needs.
• See NIHCM’s recent infographic on the uneven burden of maternal mortality in the US and our webinar on the topic.
• Arkansas has the highest maternal mortality rate in the nation and Arkansas Blue Cross and Blue Shield is addressing health disparities within maternal health.
• Blue Cross Blue Shield of Michigan is working to advance maternal health equity through its grant program focused on improving outcomes in vulnerable communities.
• Blue Cross Blue Shield of Tennessee’s first health equity report highlights facts about maternal health disparities in the state.

End of the Public Health Emergency

In early 2020, the federal government declared COVID-19 a public health emergency (PHE) and a national emergency, which increased access to resources for the pandemic response. On May 11, 2023, the PHE will expire, which will result in policy changes at the government and health system levels.

• COVID-19 Health Emergency: Under the PHE, COVID-19 vaccines, tests, and treatments were available at little to no cost. Out-of-pocket costs for these items may increase once the PHE expires.
• Extended Telehealth Flexibilities: Telehealth requirements were relaxed due to the PHE which led to wide adoption and expansion of services. Congress recently extended several telehealth flexibilities until the end of 2024, including the provision of behavioral health services.
• Medicaid Redetermination: Prior to the pandemic, states annually determined an individual’s Medicaid eligibility. However, during the PHE, Medicaid continuous coverage was established, prohibiting states from disenrolling individuals. A majority of adult Medicaid beneficiaries are unaware that states can begin eligibility redeterminations on April 1. There are several opportunities to promote continued coverage among eligible enrollees.

Resources & Initiatives:

• Learn more about the unwinding of the Medicaid continuous enrollment provision and how states can reduce the number of individuals at risk of losing coverage.
• NIHCM grantee, the Alliance for Health Policy, recently hosted a webinar on this year’s policy priorities, including the ending of the public health emergency.
• To help determine eligibility for Medicaid or CHIP coverage, visit Medicaid.gov/renewals.
• The Blue Cross Blue Shield of Massachusetts Foundation shares key strategies for policymakers and stakeholders to reduce Medicaid and CHIP coverage loss.

Artificial Intelligence and Health Care

ChatGPT, an artificial intelligence (AI) tool, and additional AI chatbot technology have recently been introduced. While AI has numerous applications, how can it safely be used in the health care field?

• ChatGPT in Health Care: ChatGPT passed parts of the US Medical Licensing Examination. It may also have the potential to aid in medical research and clinical settings, such as triaging patients and charting information.
• The Ethics of AI in Health Care: Currently, ChatGPT cannot interact with patient's protected health information in a way that would be compliant with the Health Insurance Portability and Accountability Act (HIPAA). There may be future use cases for summarizing patient data that is not protected.
• Behavioral Health: With the behavioral health workforce facing shortages, several studies are focused on AI’s ability to assist with mental health care, including through peer support. Experts warn of the importance of balancing effective AI and human interventions.

Resources & Initiatives:

• Learn more about ChatGPT in health care, including how it can be used and some limitations.
• Blue Cross Blue Shield of North Carolina is using AI to identify members at risk for serious health conditions and address them earlier on.
• Blue Cross and Blue Shield of Massachusetts is utilizing AI to detect fraudulent claims, aiming to curb health care spending and rising costs.

In Other Public Health News…

Children’s Mental Health: Parents are worried about their children’s mental health, with 40% reporting they are very concerned their child will struggle with anxiety or depression. A recent article highlights evidence of childhood adversity’s impact on the brain and how Black children are disproportionately exposed to traumatic events.

• Blue Cross Blue Shield North Carolina shares strategies to end mental health stigma in our children’s generation.

Lead Poisoning: The Food and Drug Administration proposes new limits on lead levels in baby food. Even low lead exposure can impact children’s brains and nervous systems, which can lead to learning disabilities and behavioral difficulties.

• See the CDC’s resource on the health effects of lead exposure.

Long COVID: Black Americans are having trouble accessing care for long COVID, after making up a disproportionate share of COVID-19 cases and deaths. Additionally, long COVID is challenging for caregivers, compounded by the fact that it is new and poorly understood.

• Learn more about long COVID from NIHCM’s recent infographic on what we know so far.