California is one of the latest states to agree to provide covered doula care to pregnant mothers receiving Medicaid. Despite the positive outcomes associated with doulas and the entire pregnancy process, the agreement has not been going very smoothly this time around.
The official legislation has been stalled for two years due to difficulty with rate negotiation and service inclusion. This is much longer than doula coverage amendments in other states, which went into effect as far back as 2014.
California could look to states such as Oregon, Rhode Island, and New York, which have already added this service to Medicaid programming throughout a woman’s pregnancy. However, the main concern with these new negotiations is the dollar amount Medicaid is offering as reimbursement for doulas who provide this service.
California has proposed a maximum of $450 per client, which is one of the lowest doula reimbursement rates yet. California doulas are reporting this is far from the industry standard or even a reasonable rate, especially since their work with one client involves a minimum of 12 hours of direct care. This figure is not inclusive of the research, scheduling, and planning that is also a big part of their job.
Many public health professionals are also finding fault with the rates, since they should be appropriate enough to attract quality doulas. By having the right providers involved in accepting Medicaid reimbursement, states like California will better be able to address its widening gap of health disparities.
In response to these stalled negotiations, many states are taking a second look at their rates to ensure they are sufficient enough. Coverage as a whole is important, but there is far more to consider. Reimbursement rates also play a large part in where and how often members access care.
Health insurance companies should be sure to update their reimbursement rates regularly according to economic trends and new health data. This will not only allow for more equity within the payer arena but also go a long way in attracting and retaining quality health care providers for their network.