Opening remarks at maternal health hearing indicate strong support for change

Sept. 11, 2019
“We are also the only industrialized country in the world with a rising maternal death rate.”

The House Committee on Energy and Commerce has released an announcement detailing the remarks made by its Chairman Frank Pallone, Jr. (D-NJ) during a Health Subcommittee hearing on “Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care” September 10.

“Today we are examining the often-tragic reality of the maternal health system in our nation, and a number of policies that could dramatically improve health outcomes for new mothers and their children,” Pallone said. “Every year, about 700 women die here in the United States from a pregnancy-related condition, and thousands more face severe maternal morbidity. That’s simply disgraceful. And when you compare these outcomes to other countries around the world, the United States is near the bottom. We are also the only industrialized country in the world with a rising maternal death rate.”

Pallone was referring to a new report released on September 6 by the Centers for Disease Control and Prevention which also shows a sharp increase in racial/ethnic disparities. During 2007–2016, black and American Indian/Alaska Native women had significantly more pregnancy-related deaths per 100,000 births than did white, Hispanic, and Asian/Pacific Islander women, according to the CDC report. Disparities persisted over time and across age groups and were present even in states with the lowest pregnancy-related mortality ratios and among groups with higher levels of education. The cause-specific proportion of pregnancy-related deaths varied by race/ethnicity.

“Maternal mortality and morbidity are problems that affect women throughout our country, but especially in African American and Native American communities, where women are three times as likely to die due to pregnancy-related conditions as white women,” said Pallone. “In a nation as wealthy as ours, these statistics are simply shocking and inexcusable, but I am hopeful that we can begin to turn the tide to improve maternal health,” said Pallone. “The Centers for Disease Control and Prevention estimates that 60 percent of maternal deaths in the United States are preventable, and the legislation that we are discussing today is a strong step forward.”

Pallone cited a number of the bills, including policies that follow up on the Preventing Maternal Deaths Act, which was enacted last year and designed to help improved data collection and has expanded Maternal Mortality Review Committees to all 50 states. He added that the legislation also authorizes and strengthens the Alliance for Innovation in Maternal Health and Safety (AIM) which helps physicians and health systems implement evidence-based practices that have been shown to improve patient outcomes when performed in a healthcare setting but have not yet been implemented nationwide.

Additional improvements cited by Pallone:

·  Seeking ways to improve health coverage for new mothers, especially among those who lose coverage after 60 days (CDC says one-third of all pregnancy-related deaths occur between one week and one year postpartum). 

· Extending access to regular physician check-ups and other health services to help women and their healthcare providers detect and treat health issues such as high blood pressure and heart disease, two of the most common causes of pregnancy-related death. 

More programs and commitments

“Every new mother and child deserves the best beginning possible, whether they live in the suburbs, cities or in a rural setting,” stated group purchasing organization Premier, Inc in response to Pallone and others at the meeting. “Getting at the root cause and raising the performance bar on maternal health for the nation is why Premier has launched the Bundle of Joy campaign. The goal for the Bundle of Joy campaign is to ensure mothers and babies are always at the center of care and supported by the latest evidence, the best doctors and the most successful practices. By mobilizing an alliance of 4,000-plus hospitals and health systems, 100 billion data points, the expertise of our industry partners and history of proven best practices, Premier aims to build and deploy new care delivery models, ultimately scaling proven advancements across the industry.”

Meanwhile, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the same day that is has awarded nearly $9 million to launch the Rural Maternity and Obstetrics Management Strategies (RMOMS) program. Recipients from three states, Missouri, New Mexico and Texas, will receive up to $600,000 in a planning year and up to $800,000 in three implementation years to pilot, test, and develop models that improve access to and continuity of maternal obstetrics care in rural communities.

The RMOMS program, administered by HRSA’s Federal Office of Rural Health Policy (FORHP) and Maternal and Child Health Bureau (MCHB), is a part of a suite of maternal health investments made by HRSA to support local and state level efforts to improve maternal health nationwide. The new program is unique because its network requirements detail the involvement of specific stakeholders, including rural hospitals, health centers, state Medicaid offices, and Healthy Start and home visiting programs, with the intention of developing sustainable strategies at a regional level.

Networks will develop strategies that focus on rural hospital obstetric service aggregation, developing a network approach to coordinating a continuum of care, leveraging telehealth and specialty care, and approaches to financial sustainability.