Advancing Health Outcomes for Women in Postpartum Care
Summary
In 2024, United States of Care (USofCare) and its partners committed to launch a new initiative to expand employer-based coverage of postpartum care. Initial implementation of this commitment is expected reach more than 25,000 women and their families, with the potential to impact the estimated 2.8 million women who are pregnant in the United States each year over time.This groundbreaking initiative is dedicated to revolutionizing postpartum care to ensure every new mother receives the essential care and support she needs during the critical postpartum period. With over half of births each year covered by private insurance, employers hold significant influence to shape what services their employees receive. Through this commitment, USofCare and its partners will drive the adoption of new standards for what benefits women can expect – and depend on – in their first year after childbirth.
Approach
By Fall 2024, USofCare will assemble the initial members of the Employer Impact Collaborative for Postpartum Care. USofCare will also unveil the Principles for Postpartum Coverage that all Collaborative partners commit to implement for their employees. These postpartum principles will build on prior research into best practices, while also engaging thought leaders across the health care system to ensure that postpartum care benefits meet the needs of women, including people with lived experience, health care providers, advocacy organizations (i.e. the Maternal Mental Health Leadership Alliance) , policy experts (i.e. The Policy Center for Maternal Mental Health) , as well as employer benefits experts. USofCare finds that undertaking this broad stakeholder engagement early on builds credibility and momentum for the plans that emerge. I
Throughout 2025, USofCare will work closely with Collaborative partners to develop detailed implementation blueprints serving companies of different sizes, while continuing to recruit new members with a particular focus on employers serving populations who experience the greatest disparities in maternal health outcomes. This will include undertaking qualitative and quantitative research with employees on their specific needs, and their desires, for postpartum support from their employers. Once blueprints are completed, USofCare will continue to provide implementation support to corporate partners.
In the initial phase of this effort, USofCare seeks to engage and work with at least six employers to support implementation of the blueprint, directly benefiting over 25,000 employees.
Action Plan
Q1 May-July 2024: Finalize initial group of partners, including funding partners, ahead of July 1 launch.
Q2 July-September 2024: Organize and launch the Employer Impact Collaborative with employers committed to adapting the Blueprint for their employees and collaborating to shape implementation plans . Release maternal health landscape data scan across the 50 states. Review and finalize the core principles that will guide the Blueprint with collaborative members. Announce the scope of the Blueprint and all of the inaugural co-signers at the CGI Fall 2024 event.
Q3. October-December 2024: Planning for 2025 Blueprint development and continuing partner recruitment for the Employer Impact Collaborative.
Q4. January-March 2025: USofCare will initiate qualitative assessment with Impact Collaborative partners to inform the Blueprint, including 1) Listening to employees about postpartum employer coverage needs, gaps, current benefits, and 2) Listening to employers about postpartum coverage and barriers.
Q5. April-June 2025: Complete quantitative assessment, including 1) Analyzing data on coverage needs and gaps in the maternal health landscape, and 2) Identifying differences in needs for large and medium/small employers. Continue qualitative assessment as needed.
Q6. July-September 2025: Draft Blueprint circulated for feedback from Employers Q7. October-December 2025: Final Employer Blueprint published. Updated list of employers committed to implementing the Blueprint for their employees released to the public.
Q8. October – December 2025: USofCare will publish the final Employer Blueprint and the updated cohort of employers committed to implementing the Blueprint for their employees. USofCare begins implementation support for employers.
September 2026. The USofCare team begins annual implementation needs assessment to fill in resource gaps while continuing ongoing technical implementation support to corporate partners. Also update the list of employers committed to implement the Blueprint. (Repeat in September 2027 and 2028) .
July 1 2029. Deadline for participating companies to implement Blueprint. Final impact numbers calculated and released by September.
Background
The postpartum period – up to one year after pregnancy – is critical to the maternal health journey, impacting a woman’s health, well-being and overall experience. Unfortunately, not every woman has access to the same support structure. Present coverage for postpartum care is fragmented, and there is no effort to ensure women are getting the care they need after pregnancy. Women who can access essential support services may still experience differences in care, and these differences are often reflected in racial demographics. At a time when access to comprehensive reproductive care is under attack and varies by state, improving women’s experiences and outcomes after pregnancy is more important than ever.
The data is alarming. The Center for Disease Control found that nearly two-thirds (65.3%) of maternal deaths occur in the postpartum period. The American Journal of Public Health found that late maternal deaths (between six weeks and one year postpartum) were 3.5 times more likely among Black women than white women, while The American College of Obstetricians and Gynecologists found that as many as 40% of women do not attend a postpartum visit. Maternity care is the second-highest annual health care expenditure for American employers – accounting for $1 for every $5 in health care benefits according to the Purchaser Business Group on Health. Employers that implement policies to support women’s postpartum care, like paid leave, also see greater revenue and profit per employee and lower turnover rates. With over half of births each year covered by private insurance (National Center for Health Statistics, 2023) , employers hold significant influence to shape what services their employees receive. The quickest way to improve postpartum coverage for the greatest number of women is through collaborating with employers.
Progress Update
USofCare’s initiative to expand employer-based coverage of postpartum care has stalled, at least temporarily, because companies that otherwise would be inclined to participate are monitoring the current political climate and the crackdown on “DEI” initiatives with an eye towards limiting their own liability or risk of political retribution. What USofCare hears from its corporate partners privately is that they remain committed to the spirit of expanding employer-based coverage, but they do not want to publicly associate their name with any new initiatives at least until they see how certain legal challenges play out in the courts to better understand their potential exposure. Unfortunately, as a result, USofCare does not foresee a lot of “public facing” progress being made this year until companies have more time to assess their own risk.
With that said, the USofCare team is looking for ways to pivot and form new partnerships that could lay the groundwork for future action when conditions improve. USofCare staff recently reconnected with Flory Wilson, Founder/CEO of Reproductive and Maternal Health Compass, to discuss ways that our organizations might partner together to help quietly advance both of our Commitments to Action. These and other conversations will continue in the coming year. USofCare also continues working to raise the need for better postpartum care in the public consciousness. NBC News covered USofCare’s release of state level data on the postpartum landscape and opportunities to better support women. USofCare also documented the lived experiences, emotions, bright spots, and critical points of failure across the 100-week journey for Black women in the US. USofCare could still have a path towards meeting its commitment by 2029. It will somewhat depend on how external factors unfold, while USofCare will position itself to take advantage of opportunities if and when they arise.
Partnership Opportunities
Most immediately, the USofCare team is focused on recruiting project partners, including corporate partners willing to sign on to the Blueprint and/or offer in-kind support, and additional funding partners who, with their investment, can help the project scale quickly and efficiently while setting the Employer Collaborative on the best path for success. This ongoing project investment will be critical to help the USofCare team provide partners with the right mix of tools and resources to develop actionable project blueprints and then continue to assist through the complexities and challenges of implementation.,USofCare will draw upon the organization’s experience in assembling partners from different sectors to collaborate on solution innovation in order to project manage the development of the Blueprint for postpartum coverage. The USofCare team will create the framework and assemble the supporting resources that will allow our corporate partners to engage in shaping the Blueprint for real world implementation. USofCare will hire the consultant who will advise the working group by providing technical expertise in employer sponsored insurance.