• The target trendline in the graph above represents an accepted national benchmark percentile for Medicaid programs across the country. In 2020 (for measurement year 2019) we modified the value shown to demonstrate a target based on our actual performance.  For this measure, the target is the 25^th national percentile.
• The annual reported rate captures activity during the previous calendar year.  
• This is a Healthcare Effectiveness & Data Information Set (HEDIS) hybrid measure.

This measure assesses the percentage of deliveries of live births on or between October 8 of the year prior to the measurement year and October 7 of the measurement year. For these women, the measure assesses the following facets of prenatal and postpartum care. 

• Timeliness of Prenatal Care. The percentage of deliveries that received a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization.
• Postpartum Care. The percentage of deliveries that had a postpartum visit on or between 7 and
  84 days after delivery.

These rates assess whether timely prenatal or postpartum visits occurred during pregnancy and after delivery. The intent of the measure is to assess whether prenatal and postpartum care was rendered on a routine, outpatient basis rather than assessing treatment for emergent events.

Preventive medicine is fundamental to prenatal care. Ensuring early initiation of prenatal care is an important component of safe motherhood programs that aim to improve maternal and infant health outcomes. Women who have inadequate prenatal care are at greater risk of having adverse birth outcomes, potentially because their health care provider has fewer opportunities to identify and manage conditions that can negatively impact the mother or infant.

Lack of prenatal care is often considered a high-risk factor for neonatal complications and post neonatal death. The goal of the prenatal contact is to exchange information and identify existing risk factors that may impact the pregnancy. According to the National Institutes of Health (NIH), women who utilize prenatal care can minimize their risk for pregnancy complications and negative birth outcomes. Similarly, comprehensive postpartum care is critical for setting the stage for the long-term health and well-being of new mothers and their infants. Common issues for mothers after birth include lack of sleep, fatigue, pain, stress, breastfeeding difficulties, mental health disorders and pre-existing health and social concerns. In addition, more than half of maternal deaths occur after birth.

Joint guidelines published by ACOG and the American Academy of Pediatrics (AAP) recommend a prenatal visit in the first trimester for all women.  In May 2018, ACOG also published a committee opinion recommending that all women have an initial assessment with a maternal care provider within 21 days after birth to address acute postpartum issues. The initial assessment should then be followed by ongoing care as needed and conclude with a comprehensive well woman visit within 12 weeks after birth. The Department of Defense, Veteran’s Administration (DoD/VA) clinical practice guidelines recommend a postpartum visit within six weeks, and no later than eight weeks, after delivery.

Last updated:  August 2021