Reducing Black Maternal Health Disparities in Medicaid through a Culturally-Competent Digital Health Platform and Integrated Doula Community Care

ABSTRACT In the United States, maternal health disparities disproportionately impact Black mothers, who are 3-4 times more likely to die during childbirth and 2 times more likely to experience complications. These disparities lead to increased costs for the U.S. healthcare system, with annual costs estimated at $1 billion for preeclampsia, $26 billion for premature births, and $32 billion for maternal morbidity. Many Black women do not have access to standard care, with one-third not receiving any prenatal care in their first trimester. Integrative care models that leverage digital health and community support -- specifically doula care -- can improve access to care and health outcomes for Black mothers. Digital health solutions need new techniques to effectively engage and build trust among Black women. Doulas, who provide emotional and physical support during pregnancy and postpartum, have been shown to reduce rates of C-sections and postpartum depression, but most Black women cannot afford their services. Mae Health has developed a digital health platform integrated with networks of Black doulas to reduce maternal health disparities in Medicaid. The platform tracks risk and symptoms personalized to the Black perinatal journey and coordinates care with available services offered by a member’s Managed Care Organization at no cost. Mae has contracted with 13 Medicaid plans across 6 states and aims to be live with all major Medicaid Managed Care plans by the end of 2024. To date, Mae has served over 1,400 mothers and delivered greater than 30% reductions in non-medically required C-sections and preterm births, when compared to national baseline data for Black mothers. With the right care and education, an estimated 60% of Black maternal deaths are avoidable. Access to culturally competent care, targeted monitoring, and early interventions can prevent prenatal and postpartum complications and reduce healthcare costs. Mae's approach aims to address the needs of Black mothers and ultimately lower the billions of dollars in avoidable healthcare costs.