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Rutledge, R. I., Sommers, A. S., Erickson, E., Hennessy, C. M., Bingaman, A. R., Britvec, M. A., & Crews, M. L. (2021). North Carolina pregnancy medical home. Medicaid and CHIP Payment and Access Commission (MACPAC). Medicaid and CHIP Payment and Access Commission (MACPAC) https://www.macpac.gov/wp-content/uploads/2021/09/North-Carolina-Pregnancy-Medical-Home.pdf
In 2011, North Carolina Medicaid established the pregnancy medical home (PMH) program to enhance access to comprehensive care for pregnant Medicaid enrollees and to improve birth outcomes by promoting evidence-based, high-quality maternity care across North Carolina (CCNC 2020). Participating PMH providers agree to provide coordinated and comprehensive care during pregnancy to improve both maternal and birth outcomes. In return, providers receive one-time payments for certain activities and enhanced payment rates for sets of related services (referred to as service packages). Under contract with MACPAC, RTI International conducted interviews and examined five states (Arkansas, Connecticut, Colorado, North Carolina, and Tennessee) implementing value-based payment initiatives to improve maternity care in Medicaid. This case study includes an overview of the North Carolina PMH model, details how the model is defined, describes the payment methodology, and summarizes the available research on the model’s effects on cost and quality. 1 MACPAC has also published case studies for the other study states, as well as an issue brief summarizing the key findings (MACPAC 2021a–e)
