As previously reported in Connecting the Dots, in April 2022, the Biden Administration announced an initiative to create a Birthing-Friendly Hospital designation framework to help improve U.S. maternal health outcomes. Administered by Centers for Medicare & Medicaid Services (CMS), the Biden Administration will provide this designation to help consumers make informed decisions when selecting a hospital for labor and delivery. CMS will make its Birthing-Friendly Hospital designation information publically available on its website, beginning in the fall of 2023.

To help develop criteria for the Birthing-Friendly Hospital designation, CMS issued a public-comment period in May 2022 seeking feedback on appropriate metrics. The Advocacy + Collaboration Committee responded on behalf of Lamaze to CMS’ request for feedback on in June 2022. Shortly thereafter, in early August 2022, CMS announced that it would initially base its Birthing-Friendly criteria on the Maternal Morbidity Structural Measure (MMSM), as established measure that hospitals already report to each year.  

To obtain a Birthing-Friendly designation for 2023, hospitals would need to answer “Yes” to MMSM two questions:

1. Does your hospital or health system participate in a Statewide and/or National Perinatal Quality Improvement Collaborative Program aimed at improving maternal outcomes during inpatient labor, delivery and post-partum care; and
2. Has [your hospital] implemented patient safety practices or bundles related to maternal morbidity to address complications, including, but not limited to, hemorrhage, severe hypertension/preeclampsia or sepsis? (CMS) 

In its August communication, CMS noted that while its public-comment period generated a support for such a designation, many commenters stated that the MMSM attestation is not a sufficient method for capturing quality maternal healthcare in the United States. These commenters recommended that CMS implement a more rigorous quality-reporting mechanism that includes patient-centered, evidence-based measures that truly push hospitals to focus on delivering high-quality care.(Federal Register, 2022)

CMS also recognized that the MMSM measure was just the first step in developing criteria to inform the public on birthing-friendly hospital options and indicated that at a future date, it would ask for public comment on “a more robust set of criteria” for designating hospitals as birthing-friendly. CMS would particularly seek comments about patient-experience measures that would be relevant to this designation.(Federal Register, 2022)

The Birthing-Friendly Designation is just one of several maternal-health initiatives is just one of several initiatives the Biden Administration is spearheading to improve U.S. maternal health outcomes. It aligns with its Maternal Health Action Plan, which encourages hospitals to implement evidence-based best practices for managing obstetric emergencies and address factors that lead to maternal health disparities. It also coincides with the White House’s Blueprint for Addressing the Maternal Health Crisis, which seeks to address disparities in maternal health outcomes.  

Lamaze International’s advocacy team, along with the Advocacy + Collaboration Committee, will continue to monitor CMS’ Birthing-Friendly Hospital designation plans, as well as ongoing and future maternal health initiatives from the Biden Administration. As childbirth educators, Lamaze members provide a unique perspective and expertise that helps shape the birthing experience for so many families. Lamaze educators provide invaluable insight into the area of improving maternal health outcomes, and have the evidence to support it. It’s an exciting time for childbirth advocacy—and childbirth educators’ roles in this advocacy. Stay tuned and get involved!

References

CMS Maternal Morbidity Structure Measure. https://www.cms.gov/files/document/maternal-morbidity-structural-measure-specifications.pdf

Federal Register. CMS Inpatient Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2023 Rates […]. August 10, 2022. https://www.federalregister.gov/documents/2022/08/10/2022-16472/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the

About Molly Giammarco

Molly Giammarco has consulted for professional healthcare associations for 10 eight years. As Lamaze International’s Director for Policy & Government Relations, Molly monitors legislation regulations related to maternal and child health, as well as advises the Lamaze Advocacy + Collaboration Committee.

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