What Medicaid’s Postpartum Expansion Means for Your OBGYN Practice

An increase in patient volumes over time represents an opportunity for OBGYNS to provide vital care, contribute to healthcare equity, and help improve revenue.

This blog was originally published on August 4, 2022.

With recent announcements of the postpartum expansion of Medicaid and Children’s Health Insurance Program (CHIP) benefits for eligible patients, OBGYN providers may be facing changes to their practice. Since the expansion applies on a state level for now, the location of your offices may determine how the expansion’s longer-term care promises could impact you.

For those practices that are impacted, the issue at hand is mostly one of scalability. Prior to expansion, most beneficiaries were covered for up to 60 days. Now, your patients may be eligible to receive care for up to six times longer than before. In this blog, we’ll discuss how your practice can manage the new demands of the Medicaid postpartum expansion. 

What Is the Medicaid Postpartum Expansion?

The postpartum expansion of Medicaid benefits is a continuation of existing benefits provided to eligible mothers and their infants. 

While federal regulations mandate that state Medicaid programs must provide postpartum coverage to eligible individuals for a period of 60 days, the American Rescue Plan Act of 2021 (ARP) included an opportunity for states to offer up to 12 months of postpartum Medicaid and CHIP coverage. States may also pilot an expansion under Section 1115 of the Social Security Act. 

The latest 2021 postpartum expansion includes California, Florida, Kentucky and Oregon, and, according to the Centers for Medicare and Medicaid Services (CMS), impacts up to 126,000 families. These states join another approximately three-quarters of U.S. states and Washington, D.C. in extending postpartum Medicaid eligibility. 

The agency also shared that if “all states extended pregnancy-related Medicaid eligibility to 12 months postpartum, the proportion of pregnant Medicaid beneficiaries who would remain eligible for the full postpartum year would increase from 52 percent to 100 percent, representing approximately 720,000 people annually with expanded coverage.”* 

Impact of Medicaid Postpartum Expansion

While the impact of Medicaid postpartum expansion may benefit hundreds of thousands of families, OBGYN clinics may be looking at greatly increased workloads. However, these potential increases could be seen as a multifaceted opportunity to:

• Provide vital care to patient populations with high demand, while contributing to healthcare equity in states where your clinic operates.
• Optimize workflows and interoperability for the benefit of your practice and the healthcare industry as a whole.
• Help improve revenue as a higher number of patient relationships extend for longer periods of time.

In order to realize these opportunities, you’ll need to ensure that your practice management software is powerful enough to handle the possibility of a surge in demand for postpartum OBGYN services. ModMed’s OBGYN-specific, cloud-based solution can help your practice operate more efficiently in order to manage upcoming demand. Sign up to learn more.

Scaling Your Postpartum Patient Caseloads

As with any increase in demand, your practice’s ability to scale may be one of the major determinants of how well you’re able to adjust. You can set yourself up for success by working in a centralized electronic health record (EHR) that allows you to move through visits quickly, digitally engage with patients, and easily connect with labs, pharmacies or other providers. 

Discover how technological advances in platform solutions can help your OBGYN practice adapt to the demands of Medicaid postpartum expansion. 

Streamlining OBGYN Patient Visits

Respond to more patients and reduce the administrative burden on your staff by streamlining the efforts you put into each visit:

• Eliminate multiple logins by working within a centralized platform.
• Reduce clicks, taps and scrolling with intelligent workflows that are coded specifically for obstetrics and gynecology practices
• Make check-in and checkout easier with patient portals and kiosks
• Automate eligibility verification, patient reminders and more

 When you use technology that can enhance and empower your connection with each patient, it can become easier to include more patients on your schedule. This may be extremely helpful as Medicaid postpartum expansion drives patient volumes higher over time.   

Empowering Patient Engagement

Another way to manage larger numbers of patients over time is with patient engagement tools that help save your staff time and prevent no-shows.

As Medicaid postpartum benefits expand, your patients may need additional support to ensure they make it to visits, understand orders and have the information they need to follow up on tests and procedures — especially since parents of infants tend to be busy or sleep-deprived.

Include patient engagement tools in your practice management:

• Empower your patients to update and view their health information, request appointments and request prescription refills at times that work for them, on patient portals and mobile applications.
• Request feedback in the form of automated surveys that can unlock actionable insights for your practice to improve quality of care.
• Customize and automate patient reminders to keep your patients on track.          
• Give patients the opportunity to use their phone to check into their appointments up to 24 hours in advance.        

As this patient population takes advantage of greater opportunities for healthcare, you can be an important part of their journey by making it easy on them. Your staff may appreciate patient self-service features and automation of common communications, too. 

Postpartum Expansion Growth Opportunities

Medicaid’s postpartum expansion of benefits may provide an opportunity for your practice to increase patient volume and overall revenue. If your practice can manage the scalability required to serve patient populations for longer periods of time, you may also be able to discover new opportunities to open offices in underserved areas or to acquire practices that can’t keep up with evolving healthcare demands.

The Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy notes that one of the driving forces behind Medicaid expansion is to build equity that may help overcome racial, ethnic and geographic disparities in maternal health outcomes. By taking a long view, your practice may be able to surface your own expansion opportunities that follow Medicaid expansion trends.* 

Manage Increased Volume with an Integrated Billing Solution and Analytics Platform

OBGYN practices that want to ensure they’re managing their revenue as patient volumes increase should consider a software solution with an integrated billing solution and analytics platform, with reports and insights that are easy to pull and share. These can help practices:

• Speed data collection during patient visits to build efficiency for downstream processes.
• Visualize and benchmark clinical data to discover opportunities, including volume trends and the impact of referring providers.
• See how you’re performing relative to your peers and benchmark outcomes to surface how you can improve patient care.
• Explore raw data, including patient demographics and history, prescribed medications, referral sources, exam details and billable charges. 

As Medicaid postpartum expansion increases demands on OBGYNs like you, having a streamlined, intelligent suite of software solutions can make it easier for you to provide more focused care, overcome disparities in healthcare, and improve patient outcomes. 

*Medicaid After Pregnancy: State-Level Implications of Extending Postpartum Coverage. Sarah Gordon, Sarah Sugar, Lucy Chen, Christie Peters, Nancy De Lew, Benjamin D. Sommers. December 7, 2021. HP-2021-28.

This blog is intended for informational purposes only and does not constitute legal or medical advice. Please consult with your legal counsel and other qualified advisors to ensure compliance with applicable laws, regulations, and standards.