Latest / Becker’s Payer Issues Podcast / Expanding Access to Doula Care to Improve Maternal Health with Dr. Cynthia Brown

Transcript

Expanding Access to Doula Care to Improve Maternal Health with Dr. Cynthia Brown · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Liz Caslow with the
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  Becker's Payer Issues podcast.
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  I'm thrilled today to be joined by doctor
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  Cynthia Brown, medical director and clinical lead for
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  women's health at Elevance Health. Thanks so much
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  for chatting with us today. And
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  just to get started, I would love to
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  hear a bit more about your career background.
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  And could you give us a bit of
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  an overview on your current role at Elevance?
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  Sure. Thanks, Liz, and thanks for having me
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  on your program today.
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  So, as you said, my name is Cynthia
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  Brown.
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  I am a board certified
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  obstetrician and gynecologist.
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  I've practiced clinically for twenty years prior to
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  coming to Elavance,
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  and now I serve as the medical director,
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  for women's health
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  at Elavance Health.
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  Basically, my purpose here is to advocate for
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  women. So I focus on impacting outcomes,
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  addressing inequities, and overall ex improving the experiences
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  for women
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  across all stages of their health journey and
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  really with a special
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  special emphasis on maternal health.
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  So
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  my role is really one of looking for
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  opportunities for improvement.
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  You know, I identify drivers and barriers to
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  that improvement and then
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  collaborate with lots of people,
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  in order to put all those pieces together
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  and find solutions that work for our members.
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  So I I collaborate with our clinical teams
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  in all lines of business, our local health
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  plans,
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  our public policy institute,
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  and then our community based partners as well.
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  And we evaluate the evidence, design new programs,
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  and we look to scale solutions that improve
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  member experience and outcomes,
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  like doula care that we're talking about today.
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  Yeah. I'm really excited to talk about this
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  solution with you. So just for context, for
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  the first time, some Ellevance Health affiliated employer
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  health plans will include doula services.
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  So can you elaborate
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  on that,
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  expansion? Because, originally,
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  there was some Medicaid plans. There were some
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  Medicaid plans that had doulas for several years,
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  but how did that grow to these employer
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  plans?
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  Yeah. Absolutely.
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  So as we saw maternal health complications rising
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  nationally,
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  we knew that we needed solutions,
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  that not only improved clinical outcomes but strengthened
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  the care experience for our pregnant women.
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  And when we looked across that evidence, doula
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  care consistently
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  surfaced as one of our most promising approaches.
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  So doulas, just to kinda level set, are
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  trained,
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  nonclinical,
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  people
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  who provide emotional,
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  physical, and educational support during pregnancy, childbirth,
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  and the postpartum period.
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  They are not clinicians. They don't do deliveries.
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  They really are,
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  a social support.
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  And social support is one of the most
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  consistent predictors
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  of better health outcomes.
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  And it's one of the strongest protective factors,
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  across the entire prenatal period. So when we
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  have good support,
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  we have less stress. We have less stress.
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  We have better mental and physical
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  health.
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  So our public policy institute conducted some research
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  studies, and the results showed that women who
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  had doula support
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  were more likely to carry to full term.
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  They had fewer birth weight infants.
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  They had reduced NICU admissions.
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  They had less c sections, and then they
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  had better postpartum mental health. And all of
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  these outcomes were meaningful from both, obviously, a
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  clinical perspective, but also for the member experience.
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  So,
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  typically, when we implement programs, we pilot them.
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  And we usually pilot them in the groups
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  where there's the greatest need or we can,
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  you know, make the most impact. So we
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  started in Medicaid,
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  and our research there showed our experience there,
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  showed that members receiving doula support
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  navigate their pregnancy with better confidence.
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  They have better understanding and emotional well-being, and
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  they had better birthing outcomes.
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  So then we had to take the time
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  to build the infrastructure,
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  that's needed to really bring doulas into our
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  network at scale. So this meant, you know,
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  things like establishing
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  credentialing pathways, developing reimbursement models across all our
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  states,
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  partnering with doula organizations
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  to grow the workforce that reflects the communities
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  we serve. But as a result, in 2025,
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  members in select,
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  employer sponsored health plans can now search for
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  and select doulas
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  just like they would any other in network
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  provider.
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  So in the same way that you would
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  look for a cardiologist that met your needs
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  or a dermatologist, you can now search for
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  a doula who addresses the needs of your
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  whole family during pregnancy delivery and the postpartum
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  time.
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  That's great to hear. And I wanna follow-up
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  on some of those outcomes in just a
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  moment, but racial disparities are particularly prevalent with
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  maternal health outcomes. So can you talk about
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  how doulas may address these gaps?
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  Absolutely.
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  You know, we know that maternal health challenges
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  affect women across all backgrounds,
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  and even women with higher income or advanced
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  education
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  can face poor experiences
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  and outcomes
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  simply because they don't always feel heard and
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  supported.
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  So for many families, doula care has been
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  out of reach because it wasn't traditionally covered
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  by insurance.
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  Expanding this access helps remove that barrier, and
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  it gives women more women the support that
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  they deserve.
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  Families who work with doulas often have smoother
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  experiences.
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  They have less unnecessary interventions.
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  They have more success with breastfeeding.
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  They have better emotional well-being.
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  And this is
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  even stronger. These benefits are even stronger and
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  well noted in underserved communities,
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  especially when families are paired with community based
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  doulas who understand their culture
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  and their language and their lived experience.
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  So this shared understanding then builds trust. And
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  when women feel safe and understood, they're more
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  likely to speak up about their needs and
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  their concerns, and this is really the key
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  to preventing
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  complications.
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  So at the heart of it, really, doulas
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  create a more personal,
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  kinda culturally aligned, and supportive experience for all
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  moms,
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  and that's really a pretty powerful way to
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  address long standing gaps in maternal health care.
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  Yeah.
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  So can you talk a little bit about
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  what sorts of long term savings,
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  these investments in doulas could lead to for
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  Ellevance?
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  Yes. I'm glad you asked that. You know,
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  it really starts with the member experience.
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  When women feel supported,
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  they engage earlier. They ask more questions of
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  their providers.
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  They are more likely to adhere to their
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  care plan, and then they get help before
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  these small issues turn into big complications.
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  You know, mental health and substance use are
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  two of the leading causes of postpartum
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  maternal deaths in this country. And as I
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  said before,
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  social support
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  is one of the strongest
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  protective factors across pregnancy and postpartum in its
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  ability to reduce stress and to improve mental
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  health. So doulas provide this as well.
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  They also you know, as I've said before,
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  those who have doula care have reduced c
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  sections.
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  They have less preterm births. They have less
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  NICU admissions.
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  And these are all events that have really
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  significant cost. So by having doulas involved, you
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  know, that's creating meaningful long term value.
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  So,
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  again, overall, what matters most,
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  is really that doulas are creating safer pregnancies,
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  healthier babies, and a more positive empowering experience
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  for moms.
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  So I wanted to wrap this up by
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  getting some of your final thoughts and advice
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  for other industry leaders as they focus on
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  maternal health,
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  and if they're considering possibly expanding to include
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  doula coverage.
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  My advice for other industry leaders is to
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  definitely consider doula coverage. You know, we we
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  advocate for doula care at Elevance Health because
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  it works. You know, we've done the research.
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  We've run the pilot programs,
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  and it's
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  clear that doulas help women
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  access the care that they need, and the
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  result is healthier, safer pregnancies and deliveries.
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  You know, pregnancy is such an incredibly
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  vulnerable and stressful time for people,
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  And members just wanna feel heard,
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  supported, and guided,
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  not just in the delivery room, but really
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  throughout the entire journey.
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  So doulas really help provide that continuous presence.
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  And by helping people navigate, you know, what
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  can be a complicated health care system, it
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  helps ease anxieties, it empowers them, and it
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  basically just improves,
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  outcomes and is a great you know, expanding
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  access to them is really one of the
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  opportunities all of us have in this industry
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  to elevate both the member experience
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  and health outcomes for moms and babies.
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  Well, thank you so much, doctor Brown. We
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  really appreciate having 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
• 9:10
  can visit beckers hospital review dot com. Thank
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  you. Thanks, Liz.