Lub Ib Hlis 6, 2025​​ 

SACRAMENTO — The California Department of Health Care Services (DHCS) has been selected by the Centers for Medicare & Medicaid Services (CMS) to implement its Transforming Maternal Health (TMaH) Model, a 10-year Medicaid and Children’s Health Insurance Program (CHIP) delivery and payment model designed to improve maternal health outcomes and reduce health care expenditures through a whole-person approach to pregnancy, childbirth, and postpartum care. California is one of 15 states selected to participate in the TMaH Model.​​ 

Tus Qauv TMaH yuav siv cov kev cuam tshuam uas muaj pov thawj los ntawm kev them nyiaj raws li tus nqi (VBP), them rov qab rau cov neeg muab kev pabcuam raws li cov txiaj ntsig kev noj qab haus huv ntawm tus neeg mob thiab qhov zoo ntawm kev saib xyuas, es tsis yog qhov ntau ntawm cov kev pabcuam uas tau muab. Los ntawm kev tsom mus rau kev txhim kho cov txiaj ntsig ntawm leej niam, txo cov nqi, thiab txhim kho qhov zoo ntawm kev saib xyuas, tus qauv no lub hom phiaj yog kom txo cov kev phais cesareans uas muaj kev pheej hmoo tsawg, txo qis kev mob hnyav ntawm leej niam, thiab nce kev nkag mus rau cov kws kho mob rau leej niam, xws li cov kws pab yug menyuam, cov kws pab yug menyuam, thiab cov chaw yug menyuam, rau cov tswv cuab Medi-Cal.​​ 

Qhov kev pib no yuav txhim kho lub xeev txoj kev saib xyuas niam, tshwj xeeb tshaj yog rau cov tswv cuab Medi-Cal cev xeeb tub thiab lawv cov menyuam mos, uas ib txwm muaj kev tsis sib xws hauv kev nkag mus rau kev kho mob niam thiab cov txiaj ntsig. Tus Qauv TMaH yuav tsom mus rau cov cheeb tsam uas xav tau kev pab cuam thiab cov peev txheej ntau tshaj plaws. DHCS yuav siv Tus Qauv TMaH hauv tsib lub nroog Central Valley: Fresno, Kern, Kings, Madera, thiab Tulare.​​ 

"Los ntawm kev tsom mus rau cov nroog uas xav tau kev pab ntau no, peb tab tom ua ib kauj ruam tseem ceeb los txhim kho kev noj qab haus huv thiab kev nyob zoo ntawm cov poj niam cev xeeb tub thoob plaws California, tshwj xeeb tshaj yog nyob rau hauv cov cheeb tsam uas muaj kev tsis sib npaug ntawm kev noj qab haus huv ntawm niam," Tus Thawj Coj DHCS Michelle Baass tau hais. Tus qauv no yuav tso cai rau peb sim cov kev qhia tshiab rau kev saib xyuas kev noj qab haus huv ntawm niam, kom ntseeg tau tias txhua tus tswv cuab Medi-Cal uas cev xeeb tub, tsis hais lawv keeb kwm yav dhau los lossis qhov xwm txheej, tau txais kev saib xyuas uas lawv xav tau kom muaj kev noj qab haus huv ntawm cev xeeb tub thiab yug menyuam. Kev koom tes hauv TMaH yuav ua rau DHCS muaj peev xwm ua tiav nws cov kev saib xyuas kev noj qab haus huv ntawm niam thiab txuas ntxiv nqis peev rau yav tom ntej ntawm kev saib xyuas kev yug menyuam ncaj ncees.​​ 

"TMaH muab lub cib fim tseem ceeb los txo qhov tsis sib xws ntawm kev noj qab haus huv ntawm niam los ntawm kev nce kev nkag mus rau doulas thiab midwives hauv peb cov zej zog," Shantay R. Davies-Balch, Thawj Tswj Hwm thiab Tus Thawj Coj ntawm Belonging, Love, Affinity, Community, & Kinship (BLACK) Wellness & Prosperity Center hais. Cov kws tshaj lij no yog cov neeg tseem ceeb uas tawm tswv yim rau tsev neeg, muab kev saib xyuas tus kheej thiab kev txhawb nqa tag nrho rau kev yug menyuam ua ntej thiab tom qab yug menyuam.​​ 

"Qhov nyiaj pab CMS Transforming Maternal Health txhawb nqa California txoj kev coj noj coj ua thiab kev tsim kho tshiab thaum ua ib kauj ruam tseem ceeb rau kev txo qis kev tsis sib luag ntawm kev noj qab haus huv thiab xyuas kom meej tias cov niam hauv Central Valley muaj kev nkag mus rau kev kho mob ncaj ncees," California Surgeon General Dr. Diana Ramos hais. "Qhov kev pib no ua raws li peb txoj kev cog lus los txo cov niam tuag thiab kev mob nkeeg, kom ntseeg tau tias yav tom ntej zoo rau cov tsev neeg thoob plaws California."​​ 

VIM LI CAS QHOV NO TSEEM CEEB: Cov tswv cuab ntawm Medi-Cal muaj feem pua ntawm kev tuag ntawm leej niam ntau dua li cov tib neeg uas muaj kev pov hwm lag luam. Cov txiaj ntsig kev noj qab haus huv tsis zoo ntawm cov niam tsev cuam tshuam tsis sib npaug rau cov Neeg Dub, Cov Neeg Ib Txwm, thiab Cov Neeg Xim, tshwj xeeb tshaj yog cov neeg nyob hauv thaj tsam Southern Central Valley thiab Northeastern/Northern Central Valley ntawm California.​​ 

DHCS will implement the TMaH Model in the five counties characterized by some of the highest pregnancy-related mortality rates in California, where C-sections and rates of prenatal and postpartum depression are higher than the statewide average. There is also a greater need for maternity care providers and health-related social services in these regions compared to others in California.​​ 

A STEP FORWARD IN HEALTH EQUITY: For pregnant people, particularly those in rural and underserved areas, this initiative represents a significant opportunity to access improved services that support their birthing plan. The TMaH Model is part of California’s broader commitment to addressing racial and ethnic disparities in maternal health and ensuring that all pregnant people, especially people in low-income communities, receive the support they need to safely navigate pregnancy and childbirth. TMaH is a key pillar in DHCS’ strategy to improve outcomes for pregnant and postpartum individuals.​​ 

"Qhov no yog ib kauj ruam tseem ceeb rau peb txoj kev siv zog los daws teeb meem kev tsis sib luag ntawm cov niam tsev hauv California," Palav Babaria, Tus Thawj Coj Saib Xyuas Kev Zoo thiab Kev Kho Mob thiab Tus Lwm Thawj Coj ntawm DHCS' Quality and Population Health Management tau hais. Los ntawm kev sim cov qauv kev saib xyuas tshiab, California tab tom ua tus thawj coj hauv kev txhim kho kev ncaj ncees ntawm kev noj qab haus huv, tshwj xeeb tshaj yog rau cov zej zog uas tau txais kev pabcuam tsis txaus lossis tsis muaj txiaj ntsig hauv kev nkag mus rau kev saib xyuas niam txiv raws sijhawm thiab zoo.​​ 

KEEB KWV YAV DUAJ: Tus Qauv TMaH yuav muab $ 17 lab nyiaj pab rau lub sijhawm kawm ntawm qhov kev pab cuam. CMS yuav muab cov nyiaj pab no rau DHCS ua ob theem: $8 lab thaum lub sijhawm peb xyoos ua ntej kev siv (2025-2027) thiab $9 lab thaum lub sijhawm xya xyoo kev siv (2028-2035). DHCS yuav siv cov nyiaj no rau kev pab txhawb nqa kev txawj ntse thiab kev txhawb nqa cov khoom siv uas yuav muab rau cov neeg muab kev pabcuam thiab cov neeg koom tes tseem ceeb hauv tsib lub nroog kom ua tiav cov hom phiaj tseem ceeb, suav nrog kev tsim qauv VBP uas tsom mus rau kev muab nqi zog rau cov neeg muab kev pabcuam rau kev muab kev saib xyuas zoo.​​ 

Tus Qauv TMaH yuav muab cov kev nkag siab tseem ceeb txog qhov cuam tshuam ntawm cov qauv kev saib xyuas raws li tus nqi rau kev noj qab haus huv ntawm niam. Nws yuav hais txog kev txhim kho kev sib koom tes saib xyuas, txhim kho kev cob qhia cov neeg muab kev pab, thiab muab kev txhawb nqa tag nrho uas suav nrog cov tsav tsheb ntawm kev noj qab haus huv, suav nrog vaj tse, kev ruaj ntseg zaub mov, thiab kev thauj mus los.​​ 

DUAB LOJ: TMaH sib haum nrog thiab yuav ua kom tiav rau DHCS' Birthing Care Pathway, uas yog ib daim ntawv qhia txog txoj cai thiab qauv kev saib xyuas uas npog tag nrho cov kev taug kev ntawm txhua tus tswv cuab Medi-Cal uas cev xeeb tub thiab tom qab yug me nyuam txij li thaum cev xeeb tub mus txog 12 lub hlis tom qab yug me nyuam. Txoj Kev Saib Xyuas Thaum Yug Me Nyuam tab tom raug tsim los ua ib daim ntawv qhia kev npaj rau cov koom haum hauv xeev, cov phiaj xwm saib xyuas kev noj qab haus huv, cov nroog, cov chaw muab kev pabcuam, cov chaw pabcuam hauv zej zog, kev siab hlub, thiab lwm tus neeg koom tes tseem ceeb hauv kev muab kev pabcuam rau cov tswv cuab Medi-Cal uas cev xeeb tub thiab tom qab yug me nyuam. Daim ntawv qhia kev npaj yuav muaj cov lus qhia txog txoj cai uas tsom mus rau kev daws teeb meem kev xav tau ntawm lub cev, tus cwj pwm, thiab kev noj qab haus huv ntawm cov poj niam cev xeeb tub thiab tom qab yug me nyuam los ntawm kev txhim kho kev nkag mus rau cov kws kho mob, txhawb kev kho mob hauv tsev kho mob thiab kev sib koom tes hauv kev kho mob, muab kev kho mob rau txhua tus neeg, thiab kho kom niaj hnub li cas Medi-Cal them rau kev kho mob cev xeeb tub. Tsis tas li ntawd xwb, TMaH sib haum nrog DHCS 'Bold Goals 50 × 2025 kev pib ua haujlwm, uas tau pib xyoo 2022 ua ib qho kev sib tw tsom mus rau kev txhim kho qhov zoo thiab kev ncaj ncees ntawm kev saib xyuas hauv peb qhov chaw tsom mus rau qhov tau teev tseg hauv DHCS' Comprehensive Quality Strategy: kev saib xyuas tiv thaiv menyuam yaus, kev koom ua ke ntawm kev noj qab haus huv, thiab kev saib xyuas cev xeeb tub.​​ 

DHCS twb tau siv ntau yam uas yuav tsum tau ua raws li TMaH Model thiab lwm yam kev pib ua uas yuav pab txhawb rau kev vam meej ntawm TMaH, xws li kev ntxiv doula, kev saib xyuas dyadic, thiab cov txiaj ntsig ntawm cov neeg ua haujlwm hauv zej zog; txuas ntxiv Medi-Cal kev pab them nqi los ntawm 60 hnub mus rau 12 lub hlis tom qab yug menyuam; pab txhawb kev sau npe ntawm cov menyuam yaus thiab cov menyuam mos uas tsim nyog rau Medi-Cal los ntawm kev nthuav dav Children's Presumptive Eligibility Program thiab tsim kom muaj Newborn Gateway; yuav tsum tau kuaj mob perinatal thiab kev ntsuam xyuas los daws cov kev xav tau ntawm tus neeg tag nrho; siv cov kev xav tau kev noj qab haus huv hauv zej zog cov kev pabcuam txhawb nqa hauv zej zog (piv txwv li, kev txhawb nqa vaj tse, cov pluas noj kho mob); thiab tso tawm Birth Equity Population of Focus nyob rau hauv Enhanced Care Management kev pab cuam uas muab kev tswj hwm kev saib xyuas rau cov poj niam cev xeeb tub thiab cov neeg tom qab yug menyuam tsim nyog.​​ 

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Tiv Tauj:
Chaw Ua Haujlwm Sib Txuas Lus
(916) 440-7660
www.dhcs.ca.gov​​