by Improving Maternal Health
June 23, 2020
In the midst of a global pandemic, it is often easy to overlook other underlying health crises. The nation’s opioid crisis remains a particularly multifaceted problem, requiring a coordinated approach from policy makers, health care providers, and community organizations. Maternal Opioid Use Model (MOM) by the Centers for Medicare and Medicaid Services (CMS) is the next step towards combating the nation’s opioid crisis, with specific regard to pregnant and postpartum women.
A woman’s history with illicit substances rarely begins or ends with pregnancy, despite it being one of the most motivating factors to quit. For many expecting mothers struggling with substance use disorder (SUD), their main goal is to have a safe pregnancy and delivery and to be able to take their healthy baby home and continue parenting them. However, in this critical time, fragmented systems of care often fail to support and treat women with SUD. Substance use now puts mothers and infants at high risk for poor health outcomes, such as preterm birth, low birth weight, and neonatal abstinence syndrome (NAS).
In Texas, drug overdose is the leading cause of maternal death, with 9.4 per 1,000 births affected by SUDs in 2016. In Harris County and Houston, 6.6 per 1,000 births were affected by SUD in 2016, with the primary drugs being methamphetamine, cannabis, cocaine, heroin and pharmaceuticals. As the Improving Maternal Health in Harris County: A Community Plan recommended, as a community, we must develop a comprehensive, long-term strategy that incorporates clinical, community-based and systems change strategies.
The Centers for Medicare and Medicaid Services granted funding to 10 states, including Texas, where Houston has become the main hub of implementation. Texas Health and Human Services is partnering with Harris Health System’s Ben Taub Hospital, Baylor College of Medicine, and Santa Maria Hostel to enact the MOM model of care.
Beginning in 2020, health care providers at these organizations will receive training for universal screening for SUD and begin engaging women earlier in their pregnancies for integrated care. Pregnant women at-risk for substance use disorders can be referred to multidisciplinary clinics, such as at Ben Taub, for medication assisted treatment (MAT), behavioral health care, and wraparound community services. The goal is to remove barriers that would prevent women with SUD from receiving treatment and coordinate comprehensive care management. Furthermore, given that Medicaid pays the largest portion of hospital charges related to maternal substance use, the MOM model promises to intervene at a critical time when women may be especially engaged with the healthcare system and reduce costs in the long run.
The MOM model with its current five-year cooperative funding agreement with the CMS will allow Texas to invest $750,000 in the first year of the project. The ability to meet milestones and performance goals will determine subsequent funding, which could be up to $5 million in federal funds over the five-year period to improve substance-related maternal health outcomes.
Explore the Maternal Opioid Use Model site for more information about the national movement or contact Dr. Catherine Eppes from Baylor College of Medicine for more information about the Texas program.