Latest / Becker’s Payer Issues Podcast / UnitedHealthcare Expands Doula Coverage to Improve Maternal Health Outcomes

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UnitedHealthcare Expands Doula Coverage to Improve Maternal Health Outcomes · Becker’s Payer Issues Podcast

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  Hello, everyone. This is Jacob Emerson with the
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  Becker's Payer Issues podcast. Very thrilled today to
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  be joined by doctor Rhonda Randall, who serves
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  as the chief medical officer for UnitedHealthcare's
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  employer and individual business. Doctor Randall, thank you
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  so much for taking the time to be
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  with me on the podcast today. Thank you
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  for having me. Absolutely. It's it's a pleasure.
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  And before we dive into everything we wanna
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  talk with you about, a special announcement from
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  United. I'm wondering if you could first tell
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  us a little bit more about yourself
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  and give us an overview of your role
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  at UnitedHealthcare.
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  Yeah. Thank you for asking that. I'm a
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  primary care physician and have been working with
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  UnitedHealthcare for over two decades, focused on helping
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  people live healthier lives and helping the health
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  system work better for everyone.
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  That, includes
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  our,
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  members who are going through
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  health care journeys, including those that are preventative
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  care and,
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  avoiding when we can
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  the escalation of a chronic disease and supporting
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  members
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  when they do have a significant health care
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  journey.
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  Wonderful. Well, Rhonda, thank you so much for
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  taking the time to sit down and chat
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  with us today. We're here today to talk
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  with you about some exciting news from UnitedHealthcare.
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  The company has announced a national expansion of
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  its doula offering.
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  And so throughout 2026,
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  availability is going to continue to expand to
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  additional employer groups. And by 01/01/2027,
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  about 7,200,000
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  members may have access to,
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  this expanded coverage if it's part of their
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  employer's health plan.
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  So, Rhonda, to start us off, for our
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  listeners who might not be familiar,
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  what exactly does a doula do, and what's
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  the significance of a major insurer like UnitedHealthcare
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  expanding commercial coverage around this?
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  Well, a doula is a non licensed,
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  non clinically trained advocate
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  who provides emotional, physical, and educational support, which
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  can be throughout your pregnancy,
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  during childbirth, and labor, and also in the
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  postpartum period.
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  And they don't deliver babies or provide medical
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  care like a physician or a midwife may.
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  They don't replace your doctor, but they are
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  a very valuable part of that broader care
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  team. And we're we've learned more and more
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  about that in medical literature over the last
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  several years that when a doula is working
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  alongside
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  those other clinicians who are part of your
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  care team, it can help you feel more
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  informed. It can help you feel more supported,
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  more heard throughout your care journey.
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  And there's good evidence now that there is
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  improvement
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  in preterm births, c section rates going down
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  by more than fifty two percent,
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  less babies need to be admitted to the
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  NICU when there's lower preterm births,
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  decreases of postpartum
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  depression and postpartum
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  anxiety by fifty seven percent when a doula
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  is part of the care team. So,
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  we see this as very valuable part of
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  that helping people live healthier lives.
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  And this is something that UnitedHealthcare,
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  is doing now and in 2027
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  will be doing at a very significant scale.
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  And I do wanna dive in a bit,
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  in just a bit, in terms of some
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  of the the clinical importance here, but I'm
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  also wondering what you were hearing from employers
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  themselves in regards to the demand for something
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  like this.
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  Employers are particularly
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  interested in making sure that their
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  employees and their beneficiaries
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  have better health experiences,
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  better health journeys.
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  Childbirth is one of the most common,
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  health care events that an employer
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  will
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  pay claims for their employee over the course
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  of their employment.
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  And employers are very focused on the same
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  things that we see in our nation with
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  high rates of maternal morbidity and mortality.
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  And the fact that, unfortunately,
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  that is get has been getting worse over
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  the last
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  decade or more in The United States. And
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  we see when we compare
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  US to other developed and high income nations,
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  our rates of maternal morbidity and mortality
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  are often some of the worst in the
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  world.
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  So that affects
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  employers
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  as well as it does government programs like
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  Medicaid, for example.
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  Absolutely.
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  It makes sense. And and when we're thinking
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  about
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  tackling this this national issue,
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  what does the latest clinical research say about
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  the importance of expanding this kind of coverage?
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  Yeah. So there has been, again, more and
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  more published,
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  literature in well respected
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  medical journals,
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  like Lancet publications,
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  for example,
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  that doulas
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  do have a reduction in preterm births, a
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  reduction in c section rates, a reduction in
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  NICU admissions, a reduction in postpartum
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  anxiety and depression. And all of these are
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  very meaningful
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  measures,
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  in not only outcomes, but also for employers'
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  health care costs.
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  Certainly. So this is expected to improve health
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  outcomes in this space. And I wonder beyond
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  the clinical case, Rhonda, is there a business
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  case here to,
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  do doulas ultimately save the system and and
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  employers money?
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  Well, they take a whole person approach to
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  care.
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  And I'm an osteopathic physician, so
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  team based care and whole person approach to
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  care really does matter. There's very, very strong
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  evidence,
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  in in every area that you look that
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  whole person approach to care and team based
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  care
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  provides that type of not only informational support,
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  but physical and emotional support.
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  And so we're seeing that
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  that advocacy, that coaching component
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  that comes with the doula, the support
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  that you can get during the
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  pregnancy, during that labor and delivery
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  time frame and postpartum as well,
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  which may include
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  your recovery from
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  labor and delivery and also
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  the support you need to care for your
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  newborn.
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  So,
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  this is a very important journey and evolution
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  to take something that,
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  we've been watching very carefully that we have
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  been doing with select benefit plans and in
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  select markets
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  and now
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  scaling it, in a way that only UnitedHealthcare
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  can.
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  No. Absolutely. And it's been fascinating to see
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  the wider industry,
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  really begin to to latch onto this idea
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  and roll it out like we are seeing
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  UnitedHealthcare
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  do this year.
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  Rhonda, how do you see doulas
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  fitting into broader care teams alongside OBs, alongside
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  midwives? How does this all fit together?
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  Yeah. Let's start with this. You know, there's
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  there's always,
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  a concern when you enter a new profession
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  into a care team.
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  You know, is there variation?
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  Right? Are
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  is there consistency
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  in the way that those
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  paraprofessionals
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  are trained?
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  And is there clear role definition? And do
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  we all understand
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  what our role in that team is? And,
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  over the last few years, there have been
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  an increase in training and certificate programs for
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  doulas, and that has improved their focus on
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  medical ethics,
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  boundaries,
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  collaboration
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  with physicians and midwives.
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  And that has really improved the way that
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  doulas are integrating now into maternity care instead
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  of being a separate stand alone industry.
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  Absolutely. And I know it's been interesting on
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  our side of things. We've been seeing a
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  lot of state Medicaid programs really roll out
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  coverage in this space as well. But before
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  we go, doctor Rendell, is there anything else
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  that we're missing on this topic or any
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  other final bits of advice that you would
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  share
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  with, other health plan colleagues around the country
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  looking at similar policies, looking at rolling out,
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  similar coverage in the doula space?
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  Two things. So
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  UnitedHealthcare,
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  through our philanthropic arm, the UnitedHealth Foundation,
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  has been also focused on
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  the concerns that we have with rising rates
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  of maternal morbidity and mortality in The United
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  States. And we've
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  our foundation has been very focused on building
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  that stronger future for maternal and infant health,
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  And, that has included,
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  significant
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  funding in grants, $7,000,000
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  in maternal and infant grants, which of that
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  includes 1,000,000 dedicated to strengthening and diversifying the
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  dual workforce.
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  So that
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  research and philanthropic arm, very important for UnitedHealthcare
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  and UnitedHealth Group of the UnitedHealth Foundation as
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  well.
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  And then from an employer
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  perspective,
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  UnitedHealthcare
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  now will be the first to offer the
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  dual support in employer sponsored and commercial members
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  at this scale across
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  plans nationwide.
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  And so what differentiates us there is the
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  flexibility.
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  Depending on an employer's plan,
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  men most members are going to have a
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  choice of which doula they work with and
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  when they decide to use that doula support.
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  So they can choose any trained doula, whether
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  they're in or out of network. They can
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  choose when they're deciding to work with them,
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  whether it's during pregnancy, during labor and delivery,
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  or postpartum.
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  Wonderful. It's very exciting news, for the industry,
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  I think, overall and, of course, for for
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  the members that you serve, doctor Randall. So
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  I wanna thank you for taking the time
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  to chat with us about this and for
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  sharing your expertise with our audience. We really
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  appreciate it. Thank you.
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  And to our listeners, if you'd like to
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  listen to more podcasts from Becker's HealthCare, you
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  can visit beckers hospital review dot com.