For over twenty-five years, an important strategy for reducing infant mortality and healthcare disparities in Maryland has been the early identification of individuals at risk via the Maryland Prenatal Risk Assessment (MPRA). HealthChoice regulations (COMAR 10.67.04.08C.) require that the MPRA tool be completed for all Medicaid participants at the first prenatal care visit. This is required with the expectation that OB providers and managed care organization (MCO) staff will use the MPRA in developing individualized plans of care for every pregnant individual. This includes making referrals to many of the maternal and child health benefits Maryland Medicaid offers, listed to the left. This regulation also requires that the MCOs contracted prenatal care providers will, within 10 days of completing the MPRA, forward the MPRA to the local health department in the jurisdiction in which the pregnant individual lives. The provider may not receive notifiation when their patient is contacted or recieves services.
Local health departments use the MPRA to link pregnant individuals to critical support services in the community. Aggregate MPRA data may also be used to assist local health departments in allocating resources to the neediest populations.
The current iteration of the MPRA includes questions on demographics, including race, educational level, and marital status; psychological risks, including mental and behavioral health history, social support, and self-care; medical risks, including sexually transmitted infections, body mass index, and chronic diseases; and pregnancy risk factors, including previous pregnancy outcomes and conditions, as well as late entry into care and COVID-19 vaccine status.
Policy and Guidance
