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Low-Risk Cesarean Delivery

Improving Maternal Health by Reducing Low-Risk Cesarean Delivery

As part of the Maternal and Infant Health Initiative, the Centers for Medicare & Medicaid Services (CMS) is pleased to announce the Improving Maternal Health by Reducing Low-Risk Cesarean Delivery (LRCD) Learning Collaborative, which will use two strategies to offer technical assistance to states and their partners: (1) a webinar series and (2) an affinity group.

Cesarean deliveries place birthing individuals and infants at higher risk for adverse outcomes. Reducing the rate of cesarean births for individuals at low risk from a vaginal birth provides an opportunity to improve both maternal and infant health. Nationally, the Medicaid LRCD rate was 25.9 percent in 2020, with marked disparities by race (30.6 percent among Black birthing persons and 24.7 percent among White birthing persons). As the largest single payer of pregnancy-related services, state Medicaid and CHIP agencies have an important role to play in reducing the number of LRCD births, reducing disparities, and improving health equity.

The learning collaborative will begin with a webinar series open to all state Medicaid and CHIP agencies and stakeholders demonstrating the potential impact of LRCD on maternal and infant health, describing disparities in the populations who have LRCDs, and outlining the approaches Medicaid and CHIP agencies may put in place to reduce the number of LRCD births. State Medicaid and CHIP agencies interested in putting these approaches into practice may express interest in participating in an action-oriented affinity group. This group will support the design and implementation of a quality improvement (QI) project focused on reducing LRCD births in their state.

Webinar Series

CMS invites all interested staff from state Medicaid and CHIP agencies, along with their hospital and maternity care providers, Medicaid and CHIP managed care plans, and other quality improvement partners, to participate in the Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative webinar series that began in March 2022. To register for one or more webinars in the series, go here.

Webinar #1: The Role of Medicaid in Reducing Low-Risk Cesarean Delivery: Improving Outcomes and Reducing Disparities
March 31, 2022

As the largest single payer of pregnancy-related services, state Medicaid and CHIP agencies have an important role to play in reducing the number of low-risk cesarean deliveries, reducing disparities, and improving health equity. This webinar will present data on LRCD rates and disparities. Experts will describe the initiatives (such as doula services, community health workers, maternity health homes, and others) they took to reduce the number of low-risk cesarean deliveries.

The Role of Medicaid in Reducing Low-Risk Cesarean Delivery: Improving Outcomes and Reducing Disparities (PDF, 3.44 MB) (video) (transcript (PDF, 159.06 KB))

Webinar #2: State Medicaid and CHIP Agencies and Obstetrical Partners: Working Together to Reduce Low-Risk Cesarean Deliveries
Date: June 10, 2022 at 1:00-2:00 pm ET

This webinar will focus on the importance of collaboratives, specifically on state Medicaid and CHIP agencies’ role in leading, convening, and coaching quality improvement partnerships focused on improving maternal and infant health by reducing LRCDs. Experts will describe the elements of successful collaboratives, and state presenters will share how they have worked with partner organizations to reduce the number of low-risk cesarean deliveries.

Register

Webinar #3: Using Data to Plan and Assess Quality Improvement Strategies to Reduce Low-Risk Cesarean Delivery in Medicaid and CHIP
Date: June 24 at 1:00-2:00 pm ET

In this webinar, experts will give examples of data sources and analyses that can help identify disparities and opportunities, and to focus strategies to produce the most impact. Presenters will describe how they have used data to establish a baseline and monitor progress toward reducing LRCD and improving maternal and infant outcomes.

Register

Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group

State Medicaid and CHIP agencies interested in reducing rates of low-risk cesarean delivery (LRCD) will have the opportunity to participate in an action-oriented affinity group that will support the design and implementation of an LRCD quality improvement project in their state. More information on the affinity group can be found on the fact sheet below and by attending the affinity group information session.

Information Session Webinar: Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group: Overview and Process for Expression of Interest

Date: June 29 at 2:00-3:00 pm ET

This webinar will explain the goals of the affinity group, present the overall curriculum for states, describe the data needed for LRCD quality improvement projects, and review the Expression of Interest form that states will need to submit if they are interested in participating. Technical assistance staff will be available to answer questions about the application process and LRCD affinity group activities. To participate in the affinity group, please submit an Expression of Interest form, found here , by July 15, 2022, 8:00 PM ET.

Register

Questions?

Please submit your questions to the technical assistance mailbox at MACQualityImprovement@mathematica-mpr.com.