Strong Start for Mothers and Newborns: Final Evaluation, Volume 2 (Awardee Specific Reports)

Hill I, Dubay L, Courtot B, Benatar S, Garrett B, Balvin F, Howell E, Johnston E, Allen E, Thornburgh S, Markell J, Morgan J, Silow-Carroll S, Bitterman J, Robin D, Odenhal R, Paez K, Thompson L, Lucado J, Firminger K, Sinnarajah B, Paquin L, Rouse M
Publication Year: 2018
Patient Need Addressed: Maternal/perinatal
Population Focus: Medicaid beneficiaries
Demographic Group: Women
Intervention Type: Service redesign, Staff design and care management
Study Design: Mixed-Methods
Type of Literature: Grey

The Strong Start for Mothers and Newborns initiative, funded under Section 3021 of the Affordable Care Act (ACA), aimed to improve maternal and infant outcomes for women covered by Medicaid and the Children’s Health Insurance Program (CHIP) during pregnancy. The initiative funded enhanced services through three evidence-based prenatal care models—Birth Centers, Group Prenatal Care, and Maternity Care Homes—and supported the delivery of these services through 27 awardees and 211 provider sites across 32 states, the District of Columbia, and Puerto Rico. Four-year cooperative agreements were awarded on February 15, 2013 by the Center for Medicare and Medicaid Innovation (CMMI) of the Centers for Medicare and Medicaid Services (CMS). The Strong Start awardees comprised a wide variety of organizations, including hospital and health systems, health plans, and community-based providers and agencies; only one award directly contracted with a state.

Insights Results

Overview of report
Care Outcomes

  • The intervention helped women with the greatest need and improved lives of pregnant patients and their newborns
  • Report indicated a 0.3% rate of missing intake forms; 0.0% rate of missing exit forms
  • Report indicated a 3.9% rate of item nonresponse on intake forms; 7.4% rate of item nonresponse on exit forms
  • Report indicated a 30.9%: C-section rate among women with a delivery
  • Report indicated a 12.6%: preterm birth rate among women with a live birth
  • Report indicated a 10.3%: low birthweight rate among women with a live birth
  • Care coordinators explored issues the prenatal care provider did not have time to cover, and identified problems a patient was not comfortable raising with the provider
  • Most care coordinators split their time between 2 or more sites; this made it more difficult to enroll and continuously engage patients in Strong Start
  • Data collection burden: implementing a smooth collection and reporting process took time