The MOM Model: New CMS Initiative Aims to Improve Systems of Care for Pregnant and Postpartum Women with Opioid Use Disorder

The CMS Innovation Center announced a new tool to help address the devastating impact our nation’s growing opioid crisis is having on pregnant and postpartum women and their infants. The Maternal Opioid Misuse (MOM) model is the latest approach in CMS’s strategy to tackle the opioid crisis in a key population group, expectant and new mothers.

The MOM model joins the Integrated Care for Kids (InCK) model in a series of federal CMS responses to the opioid epidemic by pledging investments to improve the systems of care for vulnerable populations of Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries, pregnant and postpartum women struggling with opioid use disorder (OUD) and their affected infants and children.

The MOM model aims to better align and coordinate the care of pregnant and postpartum Medicaid and CHIP beneficiaries with OUD and their infants through state-led delivery system reforms. The program will focus on: improving care quality and reducing expenditures for pregnant and postpartum women with OUD and their infants; increasing access to treatment, service-delivery capacity, and infrastructure based on state-specific needs; and creating sustainable coverage and payment strategies that support ongoing coordination and integration of care.

Maternal opioid use disorder has surpassed hemorrhage and hypertension as the leading cause of maternal deaths in many states across the country. CMS describes this epidemiologic trend as the rationale for launching the MOM model. Evidence also points to the fact that perinatal substance use is a major public health concern linked to several harmful perinatal and maternal health consequences, including severe maternal morbidity and mortality, preterm birth, and low and very low birthweight infants.

CMS will award a maximum of $64.4 million to 12 states over the course of the five-year model performance period. Medicaid agencies in the awarded states will be responsible for implementing the MOM model in partnership with at least one “care-delivery partner” in their communities.

I am encouraged by the momentum we are seeing across multiple sectors, including the state and federal health sectors, to elevate and systemically address the behavioral and physical health needs of pregnant and postpartum women with OUD and their infants, in tandem with their unmet basic social and human services needs.

To learn more about the MOM model, read this fact sheet and visit the home for the MOM model on the CMS website.