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Transforming Maternal Health (TMaH)

In December 2023, the Centers for Medicare & Medicaid Services (CMS) announced its intention to implement a new care model aimed at improving maternal health outcomes by expanding access to proven maternal health approaches and evidence-based providers. The Transforming Maternal Health Model or TMaH is a 10-year payment and care-delivery model that will support up to 15 state Medicaid agencies (SMAs) in developing and implementing a whole-person approach to pregnancy, childbirth, and postpartum care for women with Medicaid and Children's Health Insurance Program (CHIP) coverage. The notice of funding opportunity is slated to be released this Spring 2024 with applications due to CMS in Summer 2024.

We know that midwives are experts at providing low-intervention holistic care whenever possible while focusing on the mental, emotional, and physical needs of the people we serve. We know that midwifery-led care could reduce health disparities and address the vast maternal health and primary care provider shortages plaguing the United States. We also know that states with higher levels of midwifery integration have better outcomes for moms and babies. That said, we need your help sharing these facts with each State Medicaid Agency (SMA) across the country.

Our goal is to set ACNM Affiliates up for success prior to the release of the TMaH notice of funding opportunity. Our hope is that midwives across the country will engage with their respective SMA and educate them about the TMaH opportunity and how vital midwives, birth centers, and midwifery-led care are to improving the culture of maternity care in the United States. We want our Affiliates to work with their SMA’s on applying to be part of the TMaH model. 

ACNM encourages midwives to work with their Affiliate leaders on a campaign of support for including midwives, midwifery-led care models, and birth centers in the TMaH model. TMaH has the potential to be transformational, but it will require an “all hands-on deck” approach and that begins with engaging with and educating your state’s Medicaid agency. The national office has compiled a variety of resources for our affiliates to use during outreach to their respective SMA's, including state-specific data about midwives and midwifery care (linked below for each state).

*Please note that these fact sheets are still being vetted by ACNM state leaders for accuracy. If you have any questions or feedback about the data, please contact [email protected] and [email protected].

CMS TMaH Information:

CMS TMaH Fact Sheet

Background on TMaH Model

TMaH Payment Design Fact Sheet

TMaH Frequently Asked Questions

TMaH Model Design

State Medicaid Agency Contact Information: 

Contact Information for State Medicaid Agencies

List of State Medicaid Directors as of January 2024

Information to Share About Advanced Practice Midwives:

Sample Template Letter/Email/Talking Points to State Medicaid Agencies around CMS’ TMaH Model

Suggested Midwifery Topics to Raise with SMA's

Essential Facts About Midwives

ACNM’s Definition of Midwifery and Scope of Practice for CNMs/CMs

Number of CNMs/CMs by State
 - AMCB Data as of 8/2023

2023 GAO Report on Midwives and Midwifery Workforce in USA

2023 MACPAC Report on Midwives and Birth Centers

2023 JMWH Article on Moving Midwifery Forward

National Partnership Report on Improving Maternity Care Through Midwifery

The Commonwealth Fund 2023 Issue Brief on Expanding Access to Midwives

IMI 2023 Blueprint for Improving Maternal & Infant Health Outcomes Under Medicaid

Click here to access the 
State-Specific Midwifery Data (ACNM State Fact Sheets). Please note access to the State-Specific Midwifery Data is a ACNM Member benefit. 

To access the State-Specific Midwifery Data please login in with your ACNM member login & password.


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