What is TMaH?
CMS’s Transforming Maternal Health (TMaH) initiative is a competitive, 10-year payment and care-delivery model (January 2025-December 2035) for Medicaid programs that aims to transform how maternity care is provided, who provides it, and how to pay for care that results in improved outcomes. Fifteen state medicaid agencies will be awarded up to $17 million and provided technical assistance over 10 years In addition, the elements of the TMaH model can serve as a useful blueprint for any Medicaid agency to improve maternal health–even if they are not selected for the program. Check out our TMAH fact sheet for more information.
Why changing how we pay for maternity care matters
Our maternity care system is failing birthing people. People from communities of color, especially Black and Indigenous families, bear the brunt of this crisis, along with rural and low-income families.Donna L. Hoyert. “Health E-stat: Maternal Mortality Rates in the United States, 2022,” U.S. Centers for Disease Control and Prevention, May 2, 2024., https://dx.doi.org/10.15620/cdc/152992; Katharine A. Harrington, Natalie A. Cameron, Kasen Culler, William A. Grobman, and Sadiya S. Khan. “Rural-Urban Disparities in Adverse Maternal Outcomes in the United States, 2016–2019,” American Journal of Public Health, January 18, 2023, https://www.doi.org/10.2105/AJPH.2022.307134
How we pay for health care is a key driver of this disaster. Innovative care delivery and alternative payment models (APMs) are key pathways to achieving care that is equitable, accessible, respectful, safe, effective, and affordable.
Your opportunity: Help your state get it right
Advocates have a critical role working with State Medicaid Agencies (SMAs) to transform maternity care for people with Medicaid coverage, and the TMaH opportunity has brought this issue to the fore. Whether or not your sate is selected, you can engage with your SMA to support concrete changes that birthing people and their families need.
We recommend advocating in your state on the following five issues:
- Prioritize community collaboration
- Include the kinds of care that show proven results
- Support whole person care
- Report disaggregated data from start to finish
- Measure what matters
The ultimate success of the model will require centering leaders of the birth justice movement and others from the most affected communities throughout the entire process – from planning, to implementation, to evaluation.
Download the full Guide for Birth Justice and Community Leaders: Making The Most Of Medicaid’s Transforming Maternal Health (TMaH) Model
