Thirteen states provide doula coverage through their Medicaid programs, and another 12 are in the process of implementing coverage, according to a report from the Elevance Health Public Policy Institute.
The insurer's research arm compared outcomes for its Medicaid managed care members who received doula services versus those who did not. Patients who received doula care were less likely to have a C-section than those who did not. Those who received doula services were more likely to attend postpartum appointments and less likely to develop postpartum depression or anxiety than their counterparts without doulas.
Black patients and patients living in areas with fewer practicing OB-GYN's were more likely to use doula care, Elevance Health researchers found. Doula services are a "valuable strategy" for reducing disparities in maternal health outcomes among these groups, the researchers wrote.
Beyond implementing Medicaid coverage for doulas, states and managed care plans have to invest in building networks of doulas and make participating in Medicaid easy and worthwhile for doulas, Elevance researchers wrote.
Several payers have implemented initiatives aimed at improving access to doula care. Blue Cross and Blue Shield of Texas partnered with Huston-Tillotson University, a historically Black university in Austin, Texas, on a new program aimed at educating doulas.
Some payers, including Aetna, have implemented virtual doula networks to improve access.
Read the full report here.