Coordinating prenatal and postpartum care in Medi-Cal
Although California’s Medicaid program, Medi-Cal, covers one in three Californians, it pays for nearly one in two of the state’s 500,000 yearly births. Pregnant people* covered by Medi-Cal are less likely to receive timely prenatal care or comprehensive postpartum care relative to those covered by commercial insurance. They are also more diverse, with people of color accounting for more than 80% of all Medi-Cal births.
Neither health plans nor outpatient providers are effectively incentivized by the Medi-Cal system to invest in the prenatal or postpartum care coordination that could improve outcomes for birthing people, especially Black people, who experience much higher rates of maternal morbidity and mortality. In contrast, hospitals, where 99% of Medi-Cal births take place, do have some incentives to improve that care coordination and thus offer one pathway for innovation and progress.
CommonSpirit Health, a large national hospital system that delivers the most Medi-Cal births in California, has recognized the role they can play in improving that care coordination. They recently partnered with Docent Health, a technology-enabled care coordination company, to pilot the use of local navigators and digital engagement tools to support pregnant people before and after their births. Given the highly fragmented nature of maternity care, which can span multiple care settings, this level of coordination is critical to ensuring people receive timely and appropriate care.
CommonSpirit is now building on the success of those pilots with Docent Health to grow its partnership to include 12 hospitals in California. In support of that partnership, and other growth opportunities for Docent in the Medi-Cal market, CHCF has made a program-related investment in the company. The investment, and additional grant support, will be used to evaluate Docent’s intervention, facilitate collaboration with community-based providers, and further tailor the company’s product and personnel to meet the unique needs of birthing people of color.
*We use the terms “pregnant people” and “birthing people” to recognize that not all people who become pregnant and give birth identify as women or mothers.