Kansas report outlines strategies for closing gaps, transforming maternal healthcare

TOPEKA — A new report emphasizes Kansas’ need to improve access to maternity care in underserved areas of the state by broadening insurance coverage and telehealth services, creating regional healthcare partnerships and improving Medicaid reimbursement rates to providers.

The United Methodist Health Ministry Fund’s latest assessment of maternal health urged policymakers to provide mothers and babies better opportunity to receive healthcare by addressing geographic and racial inequities as well as workforce shortages.

The report said a majority of Kansans reside an hour away from facilities capable of dealing with high-risk pregnancies. Kansas women were twice as likely to die during pregnancy, childbirth or postpartum than 20 years ago.

David Jordan, president and CEO of the United Methodist Health Ministry Fund, said weaving together a network of nurses, physicians, paramedics, doulas, midwives, lactation consultants and other community-based providers would lessen the workforce shortfall.

In addition to better coordination within the healthcare field, he said, change should be accompanied by state financial investments to reimburse Medicaid providers at levels capable of sustaining obstetric care, including anesthesia and surgical capabilities, regardless of the number of deliveries. In Kansas during the past decade, some rural hospitals have closed or stopped offering maternity care services altogether.

“Budgets, medical plans and policies are really a statement of values. This is a perfect opportunity for bipartisan investment,” Jordan said.

The mortality rate among Kansas mothers stood at 23.1 per 100,000 live births, but the state Maternal Mortality Review Committee concluded three-fourths of these pregnancy-related fatalities were preventable. The portion of the state’s population bearing the brunt of this statistical reality reside in rural or underserved urban areas. Women on Medicaid or those with low-income ZIP codes were more likely to die. And, the maternal mortality rate for Black women was 75% higher than for white women in Kansas.

“This problem is not new but is one that is worsening,” Jordan said. “The consequences are serious. Decreased access to maternity care harms Kansas’ rural communities by threatening the lives of mothers and newborns.”

The report said providing moms and babies a healthy start in life would counter the state’s sagging overall health rankings. Expanding enrollment in Medicaid or broadening access to health insurance before, during and after pregnancy was a driver of maternal health, the document said.

Lack of affordable care prior to pregnancy leads to unmanaged chronic conditions, such as hypertension and diabetes, that significantly increase pregnancy-related risks, the report said.

Kansas would benefit from elevating community-based organizations uniquely positioned to build trust and improve outcomes for mothers and children, the document said. Persistent challenges to accessing quality care include barriers of transportation, housing, childcare, food insecurity and income inequality, the report said.

The assessment urged state officials to focus on connecting healthcare systems in ways that supported families. For example, navigators could help families understand care options, acquire referrals and coordinate appointments without sacrificing maternal autonomy.

“In rural western Kansas,” the report says, “some families rely on hospitals in neighboring states due to closer proximity and stronger referral relationships.”

The state’s maternal and child health initiatives overlap and work to improve coordination could reduce confusion and duplication, the report said.

A shared data system could reduce service fragmentation and promote evidence-based practices, the study said. The state’s healthcare system would better serve Kansans with shared universal data infrastructure, public dashboards, standardized screening protocols and improved access to race and income stratified data, the document said.