MHN ACO wins grant to put maternal health coaches in Chicago community health centers

The Medical Home Network Accountable Care Organization, LLC (MHN ACO), a wholly provider-owned entity comprised of 13 Federally Qualified Health Centers (FQHCs) and three health systems serving more than 160,000 Medicaid patients, was awarded a grant for approximately $250,000 from the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. The grant is part of HRSA’s 2021 Emerging Issues in Maternal and Child Health Program with the goal to strengthen the capacities of state and local organizations to respond to emerging public health issues affecting maternal and child health (MCH) populations.

The MHN ACO’S Maternity Health Coach Program will address two emerging priority issues in maternal and child health identified by the State of Illinois:

• Promote a comprehensive, cohesive and informed system of care for all women to have a healthy pregnancy, labor and delivery and first year postpartum.
• Assure accessibility and quality of preventive and primary care for women.

The grant-funded program, which is a partnership between the MHN ACO and Medical Home Network (MHN), a Chicago-based not-for-profit focused on transforming care in the safety net and building healthier communities, will work to fundamentally change healthcare experiences and outcomes for vulnerable pregnant patients in Chicago.

Program Builds on MHN’s Proven Care Management Model

With this grant, the MHN ACO will build on MHN’s proven care management model, in which care management teams are integrated into the ACO’s primary care practices, by adding maternal health coaches. The maternal health coach will work alongside the obstetrician/ gynecologist providers at the clinics and provide intensive support to individuals throughout the course of their pregnancy and post-partum.

“Providing skilled coaching and support to low-income families during the pregnancy journey has been critically missing for patients in our communities and has led to inconceivable disparities in care,” said Tina Spector, VP, Clinical Integration & Innovation, MHN. “Our Maternal Health Coach Program will seek to address these deep disparities by engaging patients in a trusted relationship and providing evidenced-based education and training in the community.”

MHN ACO pilot sites will incorporate a new health coaching curriculum and train individuals for the maternal health coach role to join their integrated care teams. A main focus is providing mental health support for patients, so the program will work to increase partnerships with Community Based Organizations (CBOs) that address all aspects of women’s health. MHN will leverage their technology platform, MHNConnect, to identify patients, track engagement efforts and produce quantifiable outcomes.

“Some of the key goals of the Maternal Health Coach Program are increasing the percentage of patients completing prenatal and postpartum visits, reducing post-delivery readmission rates and improving outcomes related to the social determinants of health,” said Leana Lopez, Director, Behavioral Health and Community Programs, MHN. “We look forward to seeing the positive impact this program will make on women and children in Chicago safety-net communities.”

MHN ACO pilot clinics will begin implementing this new program in the fall.