CMS model addresses opioid misuse among expectant and new mothers

A new CMS model aims to improve the quality of care and lower costs for mothers with opioid use disorder (OUD) and infants.

A new CMS model aims to improve the quality of care and lower costs for mothers with opioid use disorder (OUD) and infants. The Maternal Opioid Misuse (MOM) Model "addresses the need to better align and coordinate care of pregnant and postpartum Medicaid beneficiaries with OUD through state-driven transformation of the delivery system surrounding this vulnerable population," according to CMS. HHS Secretary Alex Azar noted, "Too many barriers impede the delivery of well-coordinated, high-quality care to pregnant and postpartum women struggling with opioid misuse, including lack of access to treatment and a shortage of providers in rural areas, where the opioid crisis is especially destructive. The MOM model will support state Medicaid agencies, front-line providers and health care systems to help ensure that mothers and infants afflicted by the opioid epidemic get the care they need." The model's objectives are to improve the quality of care and reduce expenditures for pregnant and postpartum women with OUD and their infants; increase access to treatment, service-delivery capacity, and infrastructure based on state-specific needs; and create sustainable coverage and payment strategies that support ongoing coordination and integration of care. The CMS Innovation Center will establish up to a dozen cooperative agreements with states, whose Medicaid programs will implement the model with one or more "care-delivery partners" in their communities. MOM will serve pregnant Medicaid and Children's Health Insurance Program beneficiaries with OUD who have elected to participate during the prenatal, peripartum, and postpartum periods.