It is no secret that Kentucky struggles with maternal and infant health outcomes. The state scored an “F” on preterm birth rates in the March of Dimes annual report card and is among the worst in the country for maternal mortality, reaching 25 deaths per 100,000 live births.
This year, Humana Healthy Horizons of Kentucky, which provides managed Medicaid services, partnered with ProgenyHealth to bolster maternity and NICU care management.
“We understand that when an infant enters the NICU, it is an incredibly stressful and uncertain time for families,” said Sarah Moyer, MD, chief medical officer of Humana Healthy Horizons in Kentucky. “That’s why we are dedicated to providing compassionate, comprehensive support through their NICU journey and beyond, supporting them throughout their child’s critical first year.”
Following this news, Dr. Moyer told Becker’s about other ways Humana is trying to support Kentucky’s growing families. Here are the key areas on Dr. Moyer’s mind.
Behavioral health and substance use
Dr. Moyer considers behavioral health one of the biggest pain points with maternal health in Kentucky, along with metabolic care.
Kentucky also has a relatively steep opioid overdose death rate. Humana Healthy Horizons of Kentucky collaborates with Volunteers of America Freedom House to help keep families together while a mother navigates substance abuse treatment.
Dr. Moyer said the model “helps to keep our moms and babies with substance use disorder connected and together. … [They have] the wraparound support services they need to really prevent some of the neonatal abstinence syndrome and NICU births.”
While Freedom House started in Kentucky, Humana programs in other states also work with Volunteers of America.
Doula access
Doula coverage has been a hot topic for Medicaid in recent years. In 2024, legislation was introduced in the U.S. Senate that would have required states to reimburse this care, which can often boost maternal health outcomes. State Medicaid programs have been leaning in on their own, as well.
While doula services are not on Kentucky’s fee-for-service schedule, Dr. Moyer said her team helps connect members to providers.
“We help our members get connected, if they’re interested, then the doula can invoice us directly, and we pay for it,” she said. The insurer considers this care as a “value-added benefit.”
Dr. Moyer did not have specific numbers on doula utilization, but she said, “It’s something that continues to expand every year.”
Social determinants
Transportation and childcare are top barriers that block members from receiving prenatal and postpartum care, Dr. Moyer said.
“Kentucky has a nonemergent transportation benefit, but they don’t allow other extra kids to go with,” she said.
Her team has been working with Granny’s Birth Initiative’s Doula Dash program to provide transportation resources and support visit compliance. Humana has also invested in a mobile app to facilitate transportation beyond the Louisville, Ky., area.
Dr. Moyer emphasized how her team tries to bring members into Humana’s care management program to better access value-added benefits.
C-sections in rural settings
“There’s a lot of anxiety around rural hospitals closing … especially related to OB deliveries,” Dr. Moyer said. “One of the things that I’m worried about increasing with less of the access to local care is … maybe more planned C-sections because of that.”
Humana is tracking C-sections in Kentucky to get a pulse on emerging trends in rural communities. The insurer has value-based relationships with some OB-GYN providers, offering extra bonus payments for lower C-section rates.
