A working group commissioned by Gov. Sarah Huckabee Sanders released its first report on the state of Maternal health in Arkansas Thursday.
The Maternal Health Working Group Statewide Strategic Maternal Health Plan focuses on four areas: data, reporting, and technology; health care access and Medicaid; clinical and practice improvements; and education and outreach. It lists completed and ongoing efforts to find and address factors contributing to Arkansas’ high maternal mortality rate.
The report recommends ways to streamline access to prenatal and postpartum care, which include setting up mobile maternal health units in rural counties and expanding educational resources for doctors and patients.
Background
Arkansas has one of the highest maternal mortality rates in the nation with an average of 38 deaths per 100,000 births recorded from 2018 to 2022. A 2024 fact sheet from the state Maternal Mortality Review committee found 95% of deaths from 2018 to 2021 were preventable.
Gov. Sanders signed an executive order in March to “Support Moms, Protect Babies, and Improve Maternal Health.” The order established the Maternal Health Strategic Committee, appointed state officials to the committee, and charged the group with developing a plan to improve education, quality of care, reporting, and overall maternal health rates across the state. The committee was charged with releasing an initial report by September 6.
Medicaid
The committee's subgroup on healthcare access and Medicaid recommends the state evaluate Medicaid coverage for services related to maternal health, including family planning and contraception. It also recommends establishing and expanding Medicaid and non-Medicaid services to help pregnant women get treatment for substance use.
The committee is also applying for a 10-year program targeting pregnancy-related health risks. The program from the federal Centers for Medicare and Medicaid Services would give up to $17 million to 15 state Medicaid agencies selected from the applicants. Called the Transforming Maternal Health Model, the program hopes to improve maternal health outcomes for people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).
Selected agencies will be required to develop and implement a health equity plan to promote healthcare in underserved communities. According to the Transforming Maternal Health Model webpage, agencies will also “support the extension of Medicaid and CHIP postpartum coverage to 12 months to promote preventive care, overall health, and reduction of care costs.”
Arkansas is one of only a few states that has not expanded Medicaid coverage for women for a full year postpartum. Rep. Aaron Pilkington, R-Knoxville, sponsored a bill to expand coverage in the 2023 legislative session, but it ultimately failed. Advocates have repeatedly asked lawmakers to prioritize expanding Medicaid access for women and children, saying the program helps Arkansans thrive.
The report says the state Departments of Human Services (DHS) and Health (ADH) are also working to reduce transportation barriers for pregnant women who test positive for infectious diseases to get healthcare, and for moms with newborns and children seeking pediatric care.
Clinical and practice improvements
The committee suggests reforms to clinical policy in the state to support healthcare workers. The recommendations include expanding the number of OBGYN training programs and residencies, and creating a school of midwifery in the state.
The committee also recommends creating pathways to list doulas and community health workers as Medicaid-funded providers. At least 12 other states already provide reimbursement for doulas through Medicaid.
Without enough specialty physicians to serve the whole state, Arkansans face long travel times to hospitals and limited access to prenatal and postpartum care, according to a report from the Arkansas Center for Health Improvement (ACHI).
Some women don’t see a doctor until going into labor, at which point travel times across the state can range from two minutes in urban areas to as long as 73 minutes in rural counties. The high number is partly due to the fact that only 35 hospitals in the state provide labor and delivery care.
Adding to the challenge is the cost of labor and delivery services: another report from ACHI warns many rural hospitals don’t make enough money to subsidize the costs of birthing services. Staffing shortages and financial issues have led to the closure of rural healthcare facilities in recent years, with some rural hospitals cutting labor and delivery care or shutting down altogether.
Technology
The committee's technology-focused subgroup recommended developing dashboards to track maternal health indicators and track Medicaid eligibility protocols. The subgroup also recommends creating a mobile-friendly resource to consolidate online maternal health services, education materials, and Medicaid application referrals.
The report states ADH will develop additional reports on the state of healthcare for pregnant people visiting local health units and those covered by fee-for-service Medicaid, both groups facing higher levels of risk than the average Arkansan.
It leaves the door open to “explore new technologies to further modernize” maternal health services.
According to the report, ADH has already developed a draft dashboard to track key health indicators in five pilot counties.
Education and outreach
The committee was also charged with developing a plan to increase maternal health education across the state. The “Healthy Moms, Healthy Babies” campaign would include developing a website to house a comprehensive list of resources.
This section of the report is the shortest, reporting only two action items currently underway. The committee says a request for proposals for a media campaign is in review and ADH has developed tools to promote community education for overall women’s health.
The full report is available to read here.
