News Update: IPPS and Maternal Health

The U.S. has the highest rate of maternal deaths among high-income countries

I am following up on my reporting last week regarding the fiscal year 2023 Inpatient Prospective Payment System Proposed Rule (IPPS).

A large focus on the ruling includes maternal health.  This is timely not only because of the concerning data that has been released but also because Sunday is Mother’s Day.  

In the IPPS proposed rule, the Centers for Medicare & Medicaid Services (CMS) is requesting the establishment of a maternity care quality hospital designation to be publicly reported on a CMS website. The website has not been specified yet by CMS.

Under the proposal, CMS would initially give this designation to hospitals that participated in the Maternal Morbidity Structural Measure finalized in the FY 2022 IPPS ruling for the reporting under the Hospital Inpatient Quality Reporting (IQR) Program.

CMS is proposing to add a scoring methodology related to measures around cesarean births and severe obstetric complications.  CMS is additionally looking for public comment on ways to improve health equity and reduce existing disparities around maternal care and subsequent health outcomes.  So, why is this so important, last month I reported on the growing disparities in maternal care.  In 2020 the U.S. saw a rise in maternal deaths to a case rate of 23.5 per 100,000 births.  This was not a new increase, but a continued growth in maternal deaths in our country since 2018.

The U.S. has the highest rate of maternal deaths among high-income countries, and black women are nearly three times more likely to die from pregnancy related complications than white women. To give perspective, the second worst country is France at 8.7 per 100,000 deaths, that is a delta of 14.8 deaths per 100,000 births.

The proposal by CMS is really a very limited easy first step, however it appears the causes of maternal mortality are not yet known.  The White House is continuing to focus public attention and additional funding for research and services to improve maternal health outcomes. 

Commonwealth recently highlighted a lack of health coverage and lack of access to maternal care as a possible causational factor.  CMS is also investigating and putting emphasis on improving standards of care around hypertension and complications such as hemorrhaging, preeclampsia and sepsis to impact these concerning statistics. 

Considering our approaching Mother’s Day, I would hope that we continue momentum to value the care delivery process needed for our expectant mothers.