Form CMS-10398 #76 CMS-10398 #76 Maternal and Infant Health Initiative Improving Maternal

Maternal and Infant Health Initiative
Improving Maternal Health by Reducing Low-Risk Cesarean Delivery
Affinity Group Expression of Interest Form
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the Improving
Maternal Health by Reducing Low-Risk Cesarean Delivery Affinity Group. This affinity
group will support state efforts to reduce the number of low-risk cesarean deliveries (LRCD)
among Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The affinity
group will use quality improvement (QI) science and peer learning to support states and their
partners in identifying, testing, and implementing evidence-based change ideas for reducing the
number of LRCDs and improving maternal health care. Participating state teams will meet
monthly from July 2022 to June 2024 for individual state meetings and all-state group
workshops. For more information on the affinity group, please see the fact sheet and sign up for
the informational webinar.
To participate in the affinity group, please submit an Expression of Interest (EOI) form by May
31, 2022, 8:00 PM ET. Once they receive the EOI form, CMS and the QI technical assistance
team will contact the proposed state QI team leader to discuss the state’s participation and
improvement goals.
Criteria used in selecting participants for the affinity group include:
•

Medicaid or CHIP staff leaders or co-leaders who are willing and available to work about 10
hours each month on the QI project

•

Well-articulated goals for reducing LRCD rates

•

An understanding of the challenges and opportunities faced by state Medicaid and CHIP
agencies in working to reduce rates of LRCD

•

Access to data on low-risk cesarean delivery through partners and/or vital records, and
access to other data as needed for QI

•

Identification of a well-rounded state planning team and an ability to convene and engage
partners to drive improvement

•

Demonstrated support from Medicaid or CHIP agency executive leadership

1. Project leadership: Please complete the following. Either the lead or co-lead must be from

the state’s Medicaid or CHIP agency. Note the time for this project shared between co-leads is
estimated at 10 hours/month.

Project lead
Name:

Title:

Agency name:
Phone:

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Email:

Project co-lead
Name:

Title:

Agency name:
Phone:

Email:

2. Participation goals: Briefly share your goals for participating in the affinity group, including

reducing the LRCD rate and any other outcomes you would like to improve (for example,
improving the percentage of birthing individuals receiving non-clinical support during birth,
or improving Medicaid or CHIP participation in a perinatal quality collaborative).

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3. State challenges and opportunities: Please share the following for your state, including any

data available:

a. What are the key challenges and opportunities related to reducing rates of LRCD in your
state?
b. Are you aware of any disparities in LRCD rates in your state?
c. Briefly describe the LRCD initiatives that have been implemented in your state, if any (for
example, using doulas in the delivery rooms, or establishing maternity medical homes).
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4. QI data: Quality improvement requires regular and frequent (for example, monthly or more

often) access to data that will help you learn about the impact of the changes you’re making.
What data does your state have access to or currently use to track LRCDs for Medicaid and
CHIP beneficiaries? What other data do you or your partners have access to that would
support a QI project on reducing LRCD (for example, vital records or hospital charts)? How
often are you able to get these data (for example, weekly, monthly, quarterly)?

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5. Your QI partners: Successfully reducing LRCD rates will require working with partners in

your state. In addition to the relevant state Medicaid and CHIP staff, states are strongly
encouraged to include representatives from hospitals, state hospital associations, state
perinatal quality collaboratives (where available), obstetric providers, and state obstetric
associations. States are also encouraged to work with their Medicaid and CHIP managed care
plans, health departments, their State Title V MCH Programs, and other relevant state partners
as part of their QI work. We also encourage states to include someone who can help collect
and understand your data.

In the table below, provide the names, titles, and affiliations of your proposed partners.

Name

Title

Organizational
affiliation

Email

Confirmed
(Yes or No)

6. Leadership support: State teams should have the backing of the Medicaid or CHIP director,

medical director, or other senior or executive agency leader to support the state team in
achieving their goals. Please give the name and contact information of the senior Medicaid or
CHIP official supporting your state’s participation.

State Medicaid or CHIP executive leader
Name:
Title:

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Email:
Phone:
7. Is there any other information you would like to provide?

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Thank you for your interest!
Please your submit questions to:
[email protected]
PRA Disclosure Statement The purpose of this PRA package is to collect information that is
voluntarily submitted by state Medicaid and CHIP agencies regarding participation in the LowRisk Cesarean Delivery Affinity Group. Under the Privacy Act of 1974, any personally identifying
information obtained will be kept private to the extent of the law.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-1148 (CMS-10398 #76).The time required to
complete this information collection is estimated to average one hour per response, including
the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collection. If you have comments concerning the accuracy
of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500
Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore,
Maryland 21244-1850.

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