Overview

The Maternal Opioid Misuse (MOM) model is the next step in the Center for Medicare and Medicaid Innovation’s (Innovation Center) multi-pronged strategy to combat the nation’s opioid crisis. The model addresses fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system surrounding this vulnerable population. By supporting the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery, the MOM model has the potential to improve quality of care and reduce costs for mothers and infants.

The primary goals of the MOM Model are to:

  • improve quality of care and reduce costs for pregnant and postpartum women with OUD as well as their infants;
  • expand access, service-delivery capacity, and infrastructure based on state-specific needs; and
  • create sustainable coverage and payment strategies that support ongoing coordination and integration of care.

These goals will be achieved through a variety of approaches, including:

  • Fostering coordinated and integrated care delivery: Support the delivery of coordinated and integrated physical health care, behavioral health care, and critical wrap-around services.
  • Utilizing Innovation Center authorities and state flexibility: Leverage the use of existing Medicaid flexibility to pay for sustainable care for the model population.
  • Strengthening capacity and infrastructure: Invest in institutional and organizational capacity to address key challenges in the provision of coordinated and integrated care.

Authors: Center for Medicare and Medicaid Innovation

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