Episcopal Health Foundation (EHF) commissioned Milliman to study the demographic and clinical characteristics, as well as health care utilization and costs, among those with high-risk pregnancies in the Texas Medicaid population. This study extends a 2023 report by Milliman also commissioned by EHF, expanding to include statewide data, a focus on associated risk factors, and postpartum health care use patterns.
The United States has the highest maternal mortality rate among high-income nations, with more than 80% of these deaths deemed preventable. Pregnancy-related mortality in the U.S. has risen significantly, from 7.2 per 100,000 live births in 1987 to 24.9 per 100,000 in 2020, exacerbated in part by the COVID-19 pandemic. Leading causes in the U.S. include mental health conditions, cardiovascular issues, infections, and hemorrhage.
In Texas, the pregnancy-related mortality rate was 23.1 deaths per 100,000 live births in 2020. Recent initiatives in Texas to enhance maternal health outcomes include the 2023 expansion of Medicaid health insurance coverage to 12 months postpartum through HB 12, and the 2023 authorization for Medicaid to provide case management services for non-medical needs through the passage of HB 1575. State programs like TexasAIM and Healthy Texas Women aim to improve maternal health outcomes through quality improvement initiatives and extended health care services.
To better understand the prevalence of high-risk pregnancies and risk factors known to contribute to poor maternal health outcomes among the Texas Medicaid population, we completed an analysis of health care claims and enrollment data for Texas Medicaid managed care plans from 2019 to 2021. For this analysis, we identified individuals with high-risk pregnancies and describe their demographics and health care cost experience.
