A newly established Center for Maternal and Child Health Medicaid Partnerships (CMMP) is a 5-year initiative supported by the Health Resources and Services Administration (HRSA) to strengthen partnerships and guide coordination between Medicaid, CHIP programs and Title V.
Title V is a federal-state partnership that funds programs and initiatives to improve the health of mothers and children..
Nonprofit research and consulting firm Altarum was selected to develop and lead the CMMP, which will provide training and technical assistance to help state-level public health systems increase their knowledge, identify shared priorities, update interagency agreements, maximize financial resources and sustain contributing improvements. to improve eligibility, coverage, access and quality of care for maternal and child health populations.
In a recent introductory webinar about the new center, Michael Warren, MD, MPH described its origin and some of its goals. Warren is associate administrator of the Maternal and Child Health Bureau (MCHB), part of the Health Resources and Services Administration of the U.S. Department of Health and Human Services. MCHB’s mission is to improve the health and well-being of America’s mothers, children and families. Its Title V Maternal and Child Health Services program serves 93% of all pregnant women, 99% of infants, and 61% of all children nationwide, including those with special health care needs.
Warren came to HRSA after about a decade in Tennessee state government. “I was working with the state health department on maternal and child health and I was very fortunate over the course of that time to build really strong relationships with our state Medicaid program, TennCare,” he recalled. “When we thought about the potential of connecting Title V with Medicaid, given so many shared interests, so much overlap in the populations we’re trying to serve, and moving the needle on key outcomes, those relationships were really vital. So during my time here in the office, I’ve worked with our team to say, what can we do to make sure we’re making the most of those MCH and Medicaid public health partnerships across the country?
Warren said they began talking to colleagues around the country, both on the public health side of MCH and Medicaid, and learned several things: One is that there was a great need for specific expertise in Medicaid financing on MCH issues. Additionally, there was a lot of interest in bringing together people from the different agencies, but that bandwidth was at its limit. “When we started having these conversations, we were still in the middle of the COVID response, so both Medicaid and public health partners were particularly stretched,” he said. “Then we heard that there was a great need to think through CMS policy directives so that states could translate them in a way that would improve the health and well-being of MCH populations and eliminate disparities that have long persisted.”
He said they also heard there was a real need to help state public health programs better understand the various Medicaid levers and policy options and what that meant specifically for their work in each state. Interagency agreements are actually required under Title V and Medicaid laws, but they vary greatly from state to state, so the Maternal and Child Health Bureau sought to make them as robust as possible.
They began working to raise money to finance a National Technical Assistance Center.
In terms of what the center will do, Warren talks about working in three groups. The first is to support the improvement of Title V and Medicaid interagency agreements. There are some states that have built very strong agreements over time, and others that would like to do so but need additional support, he explained. “We don’t necessarily need to reinvent the wheel, but show examples of things that have worked in states so that other states can look and consider how they might replicate that.”
The second workgroup will consist of building the knowledge base of MCH’s public health and Medicaid workforce around each other’s respective programmatic efforts and policy levers, he said. “We want to make sure that both sides have a good understanding of what the other is doing and what policy levers are available to each.”
The third work group involves technical assistance. MCH state public health executives may have an idea of how they want to partner with Medicaid on a particular issue to improve health outcomes for MCH populations. The center can say, “Here are some ideas that have worked in similar states.” That could be sample contract language for working with managed care organizations. Some lessons may have been learned for engaging state Medicaid leaders on a particular issue.
“I think this is probably one of the most transformative things we’ve done in the office, certainly in the last five years,” Warren said. “When you think about the population reach of Title V and the broad reach of Medicaid, and how vital Medicaid is to the health and well-being of MCH populations, this is truly a critical partnership, and we couldn’t be wrong.” . “I’m most excited to start this.”
