HFS announces participating providers in Transforming Maternal Health Model

The initiative aims to reduce gaps in access to care and improve maternal health outcomes through a whole-person approach to care

The Illinois Department of Healthcare and Family Services (HFS) is announcing five participating health care providers in the federal Centers for Medicare & Medicaid Services (CMS) Transforming Maternal Health Model (TMaH):

• UW Health SwedishAmerican Hospital in Rockford

• Crusader Community Health in Rockford

• Advocate Sherman Hospital in Elgin

• Advocate Condell Medical Center in Libertyville

• VNA Health in Elgin

Work will be piloted in the greater Elgin and Rockford regions, which both include a mix of rural, suburban and urban populations that have historically faced persistent disparities in maternal health and birth outcomes. The initiative aligns with the Pritzker Administration's broad commitment to advancing birth equity in the state of Illinois. This builds on earlier transformative work to improve maternal and child health under the Pritzker Administration, including Illinois becoming the first state to extend postpartum Medicaid coverage to 12 months.

"Improving equitable access to healthcare for Illinoisans as they expand their families will be transformative for pregnant and parenting persons at a critical time in their healthcare journey," said HFS Director Elizabeth M. Whitehorn. "Piloting innovative payment models will place a strong focus on value-based, high-quality care, with the collective goal of creating better maternal health outcomes across our state."

The federal program is providing up to $17 million in funding over 10 years to assist Illinois and other awarded state Medicaid agencies in developing and piloting a more integrated approach to maternal healthcare. The pilot will take a comprehensive approach to physical health, mental health and social needs throughout the pregnancy, childbirth and postpartum care continuum. Through the pilot, participating providers will implement a new value-based payment mechanism that will incentivize whole person health outcomes by rewarding health systems and providers for their steadfast support of moms and babies across the state.

The United States has a disproportionately high rate of adverse pregnancy outcomes despite spending more per capita on maternal health care than any other nation. Those outcomes are generally experienced more significantly in communities with less access to care. Currently, the Medicaid program covers nearly half of births in Illinois, which emphasizes the critical need for these types of resources.

"At UW Health SwedishAmerican Hospital, we understand that selection for this initiative comes with a profound responsibility," said UW Health SwedishAmerican Hospital Director of Women and Children's Services Jen Callison. "We are committed to leveraging this 10-year investment to strengthen infrastructure, expand services, and implement evidence-based practices that improve maternal outcomes for every patient we serve. Guided by our mission to advance health without compromise, we will intentionally focus on closing gaps in care and ensuring that those with the greatest needs-especially marginalized populations-receive the highest quality maternal care."

"We are pleased to see this investment in transforming the maternal health model to give mothers and babies the best opportunity for a healthy life," said Crusader Community Health President & CEO Sam Miller.

"Advocate Health's partnership with Illinois Medicaid and participation in TMaH reflects our commitment to shaping innovative, value-based maternity payment models that support whole-person care and advance maternal health outcomes across Illinois," said Advocate Health Vice President of Enterprise Managed Health Jennifer Houlihan.

"VNA Health Care has a long-standing commitment to addressing the evolving healthcare needs of the communities we serve, and we are honored to be part of this important investment in maternal health across the greater Elgin region," said VNA Health Care VP of Operations & Chief Operating Officer David Koch. "This initiative will strengthen our ability to deliver high-quality maternal care with an emphasis on access, and quality. By working across a diverse mix of suburban and rural communities, we aim to improve access to care and to advance improved health outcomes for mothers and families. Our approach spans the full continuum of care, integrating physical health, behavioral health, and the social factors that shape each individual's experience during pregnancy and throughout the postpartum period. This effort represents an important opportunity to design and pilot a person-centered model of care - one that closes care gaps, improves outcomes, and has the potential to be scaled to support families across Illinois."

Most of the resources awarded to Illinois will be invested in provider infrastructure, such as building out capacity to screen high risk patients, increasing supports for care coordination and interoperability, improving electronic health record capabilities, and facilitating real-time care delivery monitoring. This support will also enable states to develop a value-based alternative payment model for maternity care services, which will improve quality and health outcomes and promote the long-term sustainability of services.

Through the TMaH Model, Illinois' Medicaid program will gain valuable technical assistance and additional resources to invest with community-based providers to address existing gaps in maternal healthcare by increasing access to midwives, doulas, lactation consultants and perinatal Community Health Workers. These interventions will improve prenatal care for chronic conditions like diabetes and hypertension, reduce complicated procedures like C-sections for low-risk individuals and reduce rates of postpartum depression and anxiety.

The model's three-year pre-implementation period is underway, running through 2028. During that time, participating states are receiving technical assistance to advance each of the model's pillars. Following that period, HFS will launch a seven-year implementation period to execute the model with participating providers.