State agencies outline Medicaid pilots, extended postpartum coverage and care‑coordination pilots
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Summary
Nevada Health Authority and Department of Human Services described efforts to expand Medicaid-managed‑care supports for pregnant people, including 12‑month postpartum coverage, managed‑care case management, a hospital–MCO postpartum pilot that raised visit rates, and exploration of pregnancy health‑home models with federal match.
Laura Rich (Director, Department of Human Services) and Stacy Weeks (Director, Nevada Health Authority) told the committee the state is aligning payer and program levers to improve maternal outcomes.
Weeks explained the Health Authority’s role as a payer and noted recent changes to move pregnant women into managed care programs with enhanced services such as enhanced case management, appointment-time standards and childbirth education. Anne Jensen, Medicaid director, said about 16,000 of Nevada’s roughly 32,000 annual births are covered by Medicaid and noted a recent contract change requiring managed care organizations to provide care coordination and supports for high‑risk pregnancies and postpartum care extending to 12 months.
Jensen and agency presenters highlighted a 2025 postpartum improvement pilot where two MCOs and three hospitals adopted standardized discharge workflows, appointment reminders and care‑coordinator handoffs; initial results showed postpartum visit completion improvements of 14–34 percent in six months. The agencies said additional pilots are underway to test value‑based payments, pregnancy health home models and remote monitoring; they stressed the potential of federal matching funds for Medicaid to scale successful models.
Committee members asked about extending pilot features beyond Medicaid into exchange and commercial markets and about timelines; agency leaders said some items may require statutory authority in the next legislative session and pledged further collaboration with the Division of Insurance and the legislature.
No formal action was taken; agencies will provide more implementation detail and cost estimates to the committee.
