A message from Bridget Hurd, vice president, Inclusion and Diversity
Blue Cross, White House and CMS share common goal: Eliminating maternal health disparities

I was encouraged to learn that the White House released the Biden-Harris administration’s Blueprint for Addressing the Maternal Health Crisis in June. This was followed by the Centers for Medicare & Medicaid Services’ Maternity Care Action Plan in July. The plan outlines CMS’ approach to improving maternal health and addressing inequities in maternal health outcomes.

These developments align with ongoing efforts by both the Blue Cross Blue Shield Association and Blue Cross Blue Shield of Michigan to eliminate maternal health disparities as follows:

• The Association implemented its National Health Equity Strategy in 2021 with maternal health as an initial focus area.
• As part of Blue Cross Blue Shield of Michigan’s health equity strategy — and in support of the Association’s goal to reduce maternal health disparities by 50% in five years — we established an internal Maternal Health Disparities Workgroup.
• Blue Cross Blue Shield of Michigan developed a strategy to address disparities, social determinants of health and access to care.

It’s good to know that so many different stakeholders are committed to addressing this urgent issue.

The disparities in maternal health are significant and disturbing. Black, Native American and Hispanic women and Latinas are 2 to 3 times more likely to die from maternal (pregnancy) complications, according to the Association. And Black women had the highest maternal mortality rate of three racial or ethnic groups identified in a report* by the Centers for Disease Control and Prevention.

Also, I’m pleased to let you know that Blue Cross Blue Shield of Michigan will include an unconscious bias education requirement for providers to be designated for the Blue Distinction^® Centers for Maternity Care program. Blue Distinction Centers for Maternity Care demonstrate expertise and a commitment to quality care for vaginal and cesarean section deliveries.

Beginning in early 2023, as a part of the next designation cycle, all staff performing maternity care services at a BDC for Maternity Care facility will need to participate in unconscious bias education. We’ll bring you more information about the BDC’s Maternity Care program and the new local plan criteria requirements in the next issue of this newsletter.

The role of unconscious bias
Research indicates that unconscious bias, sometimes called implicit bias, contributes to health care disparities in a variety of areas, including maternal health. I’m often asked: What exactly is unconscious bias?

It’s important to understand that all human beings are hardwired to have bias, and biases are often based on assumptions and stereotypes that are learned over time from our different experiences and exposure. Unconscious bias refers to the attitudes, stereotypes and generalizations that affect our understanding, actions and decisions in an unconscious manner. It often results in prejudices in favor of — or against — a person, thing or group.

In a health care setting, unconscious bias can have dangerous consequences when someone’s treatment is based on their race or ethnicity, socioeconomic status, religion, gender or sexual orientation, or other factors unrelated to their symptoms or condition. That’s why, in 2020, Blue Cross Blue Shield of Michigan announced that the 40 physician organizations and their physicians participating in the Physician Group Incentive Program would be required to complete unconscious bias education. The following year, more than 5,000 providers in the Patient-Centered Medical Home designation program were required to participate in unconscious bias education to receive value-based reimbursement tied to their designation.

Based on feedback received from the providers, this education is increasing awareness, helping providers be more mindful of unconscious bias and mitigating biases that could influence health and health care disparities.

Our maternal health core measures
Following is an overview of our core measures, including a look at what we’re working on, in alignment with the Association.

In alignment with the Association, we’re focused on better understanding and eliminating disparities for:

• Severe maternal morbidities during delivery hospitalization and six weeks after giving birth
• Prenatal and postpartum care
• Postpartum depression screening and follow-up

Other measures and initiatives include:

• Reviewing the use of midwifery and identifying how to better inform members of this benefit
• Strengthening community investments and partnerships
• Using a health equity lens to identify and implement solutions for our customers
• Providing information and education through a member outreach campaign
• Informing, educating and promoting the use of gender-neutral language throughout the birth process
• Monitoring the COVID-19 vaccination rate among those who are pregnant
• Exploring how to leverage the value-based reimbursement program to strengthen processes and procedures that support reducing maternal health disparities

For more information

• See the articles about maternal health that ran in the November-December 2021 and May-June 2022 issues of this newsletter.
• Learn more about the Blue Distinction Specialty Care programs, including the Blue Distinction Centers for Maternity Care program.
• Contact me at BHurd@bcbsm.com if you’d like to join our Maternal Health Workgroup or need more information.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.