Scope of Covered Services for Maternity Care

Widespread discriminatory practices create barriers for women to obtain coverage for maternity care services in private insurance markets. Among low-income women, many are eligible for Medicaid coverage only during their pregnancy, leading to delays in care and lack of coverage for critical early prevention and  adequate follow-up in the postpartum period. Lack of consensus on a comprehensive package of essential maternity services leads to missed opportunity to deliver effective, high-value services and the wastefulness of delivering services that are ineffective, compare unfavorably with other options, or are provided outside of supported indications.

Read more about maternity service coverage PROBLEMS and system GOALS >>

Major Recommendations

  1. Identify an essential package of evidence-based maternity care services for healthy childbearing women and newborns, and additional essential services of benefit to women and newborns with special needs.
  2. Carry out research to evaluate the comparative effectiveness and safety of priority maternity services that require further evidence before they can be considered for inclusion in the essential services list.
  3. Use determinations about comparative effectiveness of maternity services to make coverage decisions and improve the quality of maternity care.

Learn more about the ACTION STEPS for implementing these recommendations. >>

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