Background
In 2019, the State of Maryland collaborated with the Center for Medicare and Medicaid Innovation (CMMI) to establish the domains of healthcare quality and delivery that the State could impact under the Total Cost of Care (TCOC) Model. As a result of the collaboration with CMMI, the State entered into Memorandum of Understanding (MOU), that required Maryland to provide a proposal for the Statewide Integrated Health Improvement Strategy (SIHIS) to CMMI by December 31, 2020. SIHIS aligns with statewide efforts across three domains that are interrelated: 1) Hospital Quality 2) Care Transformation Across the System and 3) Total Health Population: (a) Diabetes (b) Opioid Use Disorder and (c) Maternal and Child Health. Within the Maternal and Child Health domain, there are two goals:
- To reduce the severe maternal morbidity rate, and
- To decrease asthma-related emergency department visit rates for ages 2-17.
Severe maternal morbidity (SMM) is defined by the U.S. Centers for Disease Control and Prevention (CDC) as “ unexpected outcomes'' of labor and delivery that result in significant short-or long-term consequences to a woman's health. For more information about SIHIS’s maternal and child health goals, please visit the Health Service Cost Review Commission (HSCRC)’s SIHIS webpage here. In 2024, Maryland was awarded a grant from the Centers for Medicare and Medicaid Services (CMS) to fund its new States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Implementation will begin on January 1, 2026 and builds upon the work of SIHIS.
Maternal and Infant Health Initiatives Related to SIHIS
Maternal Health Improvement Strategic and Action Plan
The Maternal Health Task Force has developed a Maternal Health Improvement Strategic and Action Plan that includes many of the initiatives below. The Task Force is staffed and convened by the Maryland Department of Health (MDH) to address the needs of pregnant and postpartum people in Maryland. The Maternal Health Task Force is a requirement by the Health Resources Service Administration as part of the Maternal Health Improvement Program or MDMOM. MDMOM is currently led by Johns Hopkins University.
The task force brings together a diverse group of key stakeholders, including officials from state health governing bodies, departments, and agencies; professional organizations; maternity health care providers; insurance payers; patient advocacy groups and local community organizations.
Public Health Grants Made Available by the HSCRC
The Prevention and Health Promotion Administration (PHPA)/Maternal and Child Health Bureau (MCHB) within the Maryland Department of Health (The Department) has provided grant opportunities for expanding evidence-based and promising practices in home visiting and CenteringPregnancy, group-based prenatal care. The funding is made available by the HSCRC to support SIHIS Initiatives. More information about HSCRC and SIHIS Annual Reports can be found on the HSCRC Webpage.
