KanCare Maternal Health Team

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KanCare Maternal Health Team

Supporting Healthy Pregnancies, Births and Postpartum Care in Kansas

Key Points

• Policy changes in KanCare have extended postpartum Medicaid coverage from 60 days to 12 months for beneficiaries and have expanded the care team by allowing reimbursement for services provided by lactation consultants, community health workers and doulas. Reimbursement rates were also increased for community health workers and Certified Nurse Midwives.
• KanCare is required to provide federally mandated maternal services, including prenatal, perinatal and postpartum care.
• New Managed Care Organization (MCO) contracts, effective in 2025, build on federal requirements by adding care coordination, mental health supports and parent education, with additional services for high-risk pregnancies.
• MCOs may also offer value-added benefits, including grocery and breastfeeding support, transportation and parenting programs, that go beyond required services to help meet the social and practical needs of families.

Introduction

Recent updates to Kansas Medicaid (KanCare) policies and Managed Care Organization (MCO) contracts have expanded the maternal care team and added services for beneficiaries who are pregnant. KanCare operates under a Medicaid managed care model, meaning MCOs are responsible for providing services to KanCare members, including pregnant individuals.

Under KanCare 3.0, new MCO contracts have expanded services for maternal care, requiring coverage of key prenatal and postpartum services and continuous supports such as care coordination, mental health services and parent education, with expanded services required for high-risk pregnancies. MCOs may also offer value-added benefits that go beyond required services to support Kansas families. Recent state policy changes have added new professionals to the maternal care team and increased reimbursement rates for existing providers. These changes reflect a shift toward a more comprehensive care team approach under KanCare, which creates a stronger foundation for maternal care services available for KanCare beneficiaries.

Who Is on the Maternal Care Team?

The KanCare maternal care team includes traditional and community-based health care providers (Figure 1). They support individuals through pregnancy, birth and postpartum. In recent years, KanCare has expanded the types of providers to include more community-based roles that extend care beyond the doctor's office. The expanded provider options increase opportunities for access to services that support every phase of pregnancy.

Figure 1. KanCare Maternal Care Team

Source: Kansas Health Institute analysis of Kansas statutes, KanCare Medical Assistance Program (KMAP) General Bulletins, U.S. Breastfeeding Coalition Lactation Support Provider (LSP) Descriptors Resource, American College of Nurse-Midwives Comparison Chart, and Kansas State Plan Amendments.

What Policies Shape the Expanded Care Team?

Starting in 2018, significant policy changes have been implemented to increase access and improve outcomes for KanCare beneficiaries. Effective April 1, 2022, Kansas extended postpartum coverage for those who are pregnant with Medicaid or Children's Health Insurance Program (CHIP) coverage. The coverage now lasts 12 months, compared to the previous two-month limitation. This marks a significant policy change to help expand access to care, improve postpartum health outcomes and reduce health disparities. Since then, KanCare has increased reimbursement rates for Certified Nurse Midwives (CNMs) and added new maternal care team members who can bill KanCare for services provided (Figure 2).

Figure 2. Select KanCare Policy Changes Related to Maternal Care

Note: Policies included in the figure above may not be reflective of all policy changes related to maternal care and KanCare.

Source: Kansas Health Institute analysis of KanCare Medical Assistance Program (KMAP) General Bulletins and Kansas Department of Health and Environment (KDHE) Policy and Billing Guidance documents from 2018 to 2025.

How MCOs Are Supporting Maternal Health

While core maternal care services, such as prenatal, perinatal and postpartum care, are federally mandated, Kansas' new MCO contracts, effective Jan. 1, 2025, place greater emphasis on maternal health by explicitly detailing these services and including requirements for care coordination and education. In addition to these core services, MCOs have the option to provide additional services to their beneficiaries (Figure 3).

Figure 3. Value-Added Benefits by KanCare Managed Care Organization (MCO), July 2025

Source: Kansas Health Institute analysis of KanCare Value Added Benefits for 2025.

Final Thoughts on Integrating Policy and Practice for Maternal Care

In recent years, KanCare policies have been implemented that expand the maternal care team to include doulas, community health workers and lactation consultants. Policy changes also include increasing reimbursement for Certified Nurse Midwives. Working in partnership with clinical care team members, this expanded team can provide more holistic and community-based care that extends beyond the doctor's office. By combining policy changes, expanded managed care organization contract requirements, and additional services offered by MCOs through Value Added Benefits, KanCare is positioned to better support pregnant and postpartum individuals with both clinical and non-clinical care. These efforts help address the medical, social, emotional and logistical needs of those who are enrolled in KanCare.