DC Council Passes Postpartum Coverage Expansion Amendment Act of 2020, Includes Digital Health Reimbursement Mandate

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Babyscripts founder pivotal in modifying language to better serve moms in the District through technology

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We know that digital health improves health outcomes, and it’s clear that increasing the uptake, utilization and efficacy of digital health will continue to be a top priority in DC.

On July 21, 2020, the DC Council unanimously passed an amendment to the Telehealth Reimbursement Act of 2013 including a digital health reimbursement mandate with language proposed by Juan Pablo Segura, co-founder and President of Babyscripts, the leading virtual care platform for managing obstetrics. Segura brought the need for such a mandate to the attention of the Council, through a grassroots effort that included meetings with Council members and solicitations of support from major stakeholders like the March of Dimes, the Preeclampsia Foundation, and the American College of Obstetricians and Gynecologists.

Segura testified before the Council on the positive impact of technology for managing pregnancy and postpartum care, and proposed an amendment to mandate reimbursement to the provider for digital tools, which would remove a major barrier to adoption. The language proposed by Segura appears in the bill that was passed unanimously by the Council and is one of the first mandates of its kind to be proposed into law. With over six years of experience in the space and a recognized leader on the future of digital health in maternity care, Segura uniquely understands the benefits of virtual care for the underserved and the barriers presented by the lack of financial incentives for providers.

The bill, introduced by Council Member Vincent Gray, seeks to extend postpartum inpatient and outpatient benefits to at least a year after childbirth, and to require the Mayor to seek approval from the Centers for Medicare and Medicaid Services that all health policies offered through the District’s Medicaid program cover inpatient and outpatient maternity and newborn care for at least one year after childbirth. Currently, women who become Medicaid-eligible solely based on their pregnancy status are limited to coverage for the duration of their pregnancy plus 60 days postpartum.

The digital health specific reimbursement mandate included in the bill, one of the first of its kind in the U.S., seeks to ensure that all mothers have access to innovative models of care regardless of risk. The mandate will require Medicaid and the D.C. Healthcare Alliance to provide coverage for home visits via telehealth for pregnant women and to provide coverage for provider-delivered digital health interventions such as remote patient monitoring, patient engagement services, and social determinant screening services

This mandate is a crucial addition to the bill, as digital health tools have been shown to resolve some of the structural barriers to perinatal care experienced by the underserved that feed into the nation’s high maternal mortality and morbidity rates, particularly acute in the DC area. According to the most recent data from the Kaiser Family Foundation, 9.3% of pregnant mothers in DC did not receive prenatal care until their third trimester, and 32.2% of mothers in DC did not receive adequate prenatal care (2018). In the postpartum period, though more than 60% of maternal deaths occur after the birth of the infant, and 44% of deaths within the first six weeks after delivery, new mothers do not have a postpartum appointment until 42 days after delivery. According to the CDC, 60% of these deaths are preventable.

Digital tools open up access to care, education, and monitoring for these mothers who may have challenges related to social determinants of health, such as transportation concerns, food and housing insecurities, and discomfort with the healthcare system, among other issues. Access to remote self-measured blood pressure monitoring, weight management, educational resources, mental health screenings, glucose monitoring, and other vital resources from the comfort of home is a critical step toward closing the gaps in maternity care for mothers in DC.

“DC is ground zero for maternal health care — we have some of the highest rates of maternal mortality in the country and there’s no excuse for it,” said Juan Pablo Segura. “The city is starting to take some really significant measures to provide better care of our mothers, but if we’re going to actually achieve better outcomes, digital health has to play a role. Without financial incentives, most providers can’t afford to implement digital tools in their practice, so including this mandate in the proposed bill is a major step toward removing that financial barrier and accelerating adoption.”

“With this mandate, DC is leading the country in new ways to improve health outcomes. This step towards digital health reimbursement is the latest in a string of initiatives that show DC’s dedication to expanding the use of virtual care,” said Osazee S. Imadojemu, MPH, former Deputy Committee Director for the Committee on Health at the DC Council. “We know that digital health improves health outcomes, and from my five years with the District government, it’s clear that increasing the uptake, utilization and efficacy of digital health will continue to be a top priority in the city.”

The Postpartum Coverage Expansion Amendment Act 2020, including the Digital Health Reimbursement Mandate with the language proposed by Segura, was passed unanimously by the Council, and is currently under Mayoral review. Pending Mayoral and Congressional approval, it will be passed into law.

About Juan Pablo Segura & Babyscripts

Juan Pablo is an active voice in advocating to improve access to innovative models of care for the underserved. He is a board member of Heathtech4Medicaid and a frequent speaker on the subject of digital health for Medicaid and low-income populations. In 2014 he co-founded Babyscripts, a virtual maternity care company delivering a new model for prenatal and postpartum care that is transforming the way expectant mothers use technology to work with their healthcare providers. Babyscripts has spent the last six years delivering the most-implemented mobile clinical solution for remote monitoring in pregnancy, with the mission to eliminate maternal mortality and improve access to care for all mothers, and was recently named to CB Insights’ Digital Health 150. For more information on Babyscripts virtual care solution and to request a demo, visit http://www.babyscripts.com.

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Stacy Callahan
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