Institute for Medicaid Innovation: Team Kentucky Site Visit

On March 3rd, 2023, with the backdrop of a severe windstorm, dedicated KY Midwifery Learning Collaborative (MLC) members met with the IMI MLC project team members: Karen Shea, MSN RN, and Rebecca Johnson, MA MPH, and MLC National Advisory Committee member Cathy Collins-Fulea, DNP CNM FACNM in Louisville, KY. The event was hosted by Granny's Birth Initiative of Louisville.

The event was kicked off by Team Leads Dee Polito and Vicki Burslem, they presented The Milestones, Success, Challenges, and the Future which was a summary of how key stakeholders came together in 2021 after being exposed to "Improving Maternal Health Access, Coverage, and Outcomes in Medicaid."  Kentucky MLC members were motivated to apply for this opportunity after having participated in the Institute's 8 Part Virtual Learning Series, an engaging and interactive virtual learning series that provides a roadmap to explore next steps for implementation of midwifery-led models of care within Medicaid.  

The KY-MLC team was able to look back and examine the SMARTIE Goal that emerged after ten foundational sessions and served as a focus of our statewide initiatives. The KY-MLC goal is to  "conduct a multi-media, equity-focused educational campaign targeted to the general public–with a focus on Medicaid recipients, healthcare administrators, and legislators to improve Kentucky's overall awareness of the midwifery-led model of care’s impact on birth outcomes, equity in healthcare, reduction of disparities and ultimately the opportunity to improve the status of maternal health in the Commonwealth."

We then heard from MLC Team KY Community Advocacy Groups & Medicaid Managed Care Organizations - Panelists and presenters included Alexa Hughes, Executive Director of Granny's Birth Initiative; Renee Basham, Executive Director of Hope's Embrace; Mary Kathryn Delodder, Director of Kentucky Birth Coalition; Holly Owens, Process Improvement Coordinator, Anthem; Lauren Buchwald, Care Manager, Humana; and Angie Chisholm, University of Kentucky Midwife Clinic representative. Each panelist gave a presentation which was moderated by Karen Shea, IMI MLC project team member.

The event concluded with a presentation from Alisha Morgan, DNP CNM FACNM who presented on the "Oasis Project - Changing the Landscape of a Maternity Care Desert" which defined counties in which access to maternity health care services is limited or absent, either through lack of services or barriers to the ability to access care within the county. An astounding 48.3% of counties in Kentucky are maternity care deserts and 16.7% of counties have low or moderate access to care. Using the O.A.S.I.S. tool (Operational Assessment, Systems Improvement/Investment, and Sustainability). Dr. Morgan summarized the benefits of adding Certified Nurse Midwives to the services of Taylor Regional Hospital and highlighted the accomplishments of CNM integration and offered an exciting example of how to improve care in rural Kentucky communities.