Ensuring that individuals receive proper care and support during their pregnancy journey is essential for the health and well-being of both parent and child. CHPW participated in several initiatives and partnerships within the community to improve access to quality pregnancy and maternal health care, while remaining flexible and responsive to the needs of CHPW members.

Expanding community awareness of midwifery care

CHPW’s Erin Hafer, Senior Vice President of Delivery & Health Systems Innovation, and Shanna Widener, Senior Director of Care Management, were part of a Washington State-based Medicaid and Midwifery Learning Collaborative team that demonstrated how state agencies and health plans can partner in support of midwifery efforts. In August 2024, the case study detailing the collaborative was published online by the Institute for Medicaid Innovation (IMI), a national 501c(3) nonprofit organization that provides innovative Medicaid solutions.

The National Medicaid and Midwifery Learning Collaborative was a three-year initiative to advance midwifery-led care for Medicaid members, ending in 2024. Five state-based teams, selected through a competitive application process, received technical assistance and guidance from the IMI and a dedicated national advisory committee to develop sustainable initiatives to advance midwifery-led models of care.

Team Washington included CHPW, Washington-practicing midwives, and the Washington Health Care Authority (HCA) among others. Through the collaborative, the group worked to create strategies to educate and engage Medicaid members in midwifery services. After identifying that midwives had limited resources to promote and educate about their services, the team designed a social media toolkit for midwives to use.

Taking learnings from the collaborative, CHPW also reviewed its current contracts with midwife groups and birth centers and added new providers to its network as well as providing resources to raise awareness around midwifery care. To support the effort, CHPW added information about midwifery care to its Apple Health (Medicaid) website, and educational materials were developed for CHPW’s Maternal Child Health Case Managers to use when connecting members to midwives.

Washington State-based Medicaid and Midwifery Learning Collaborative team

There is strong evidence that birth doula services are associated with improved perinatal and birth outcomes, which is why CHPW is following Doulas for All coalition’s lead in their work to make doula coverage available to Apple Health (Medicaid) members. In May 2024, the coalition secured legislative funding from Washington State for a birth doula benefit at the highest reimbursement rate in the nation. The benefit became available January 1, 2025.

As a result of the Doulas for All coalition’s grassroots efforts during the 2024 legislative session, the Health Care Authority (HCA), the state agency who oversees Apple Health (Medicaid) in Washington, was authorized to implement a doula benefit for Apple Health clients, allocating funding for doula reimbursement and a statewide doula referral system.

The coalition is now helping doulas to earn state Department of Health credentials.

One of CHPW’s 2024 legislative priorities was to make sure Medicaid reimbursement for birth doula services and the referral hub were fully funded. Reimbursement from the state’s funding for Apple Health was approved as a Fee-for-Service benefit in its early years, transitioning to a managed care organization (MCO)-covered benefit in the future.

CHPW was the first MCO to participate in the coalition’s meetings, represented by CHPW Public Policy Analyst, Hawa Elias, who had two primary goals: listen and learn to how we can best support birthworkers, and be present with the community as we design a system to better care for members.

Elias explains, “Attending coalition meetings to learn from doulas is foundational, keeping us grounded in the needs of the community, as we build programs to improve maternal health. It’s important for CHPW to follow the lead of such birthworkers, who have historically supported birthing people throughout the prenatal, delivery, and postpartum periods. They know best how to provide culturally competent care, and to improve maternal health outcomes.”

To improve awareness of and access to CHPW pregnancy health care benefits and services, we created an online guide for CHPW Apple Health members. The CHPW site went live in October 2024.

Dubbed the Pregnancy Care Resource Hub, the new web experience quickly established itself as a trusted resource for members to access health information for every stage of pregnancy and the postpartum period including newborn health, alongside benefit and services information.

The online resource center prioritized insights from CHPW teams working directly with members who provided feedback about navigating pregnancy care benefits with Apple Health.

Additionally, Maternal Health Case Managers and Behavioral Health Directors supported efforts to write a blog series on pregnancy care topics, shared across our social media channels, with community partners, and directly to members to increase awareness around pregnancy care resources, benefits, and midwifery care.