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The U.S. has one of the highest maternal morbidity rates in the world among wealthy nations, with an estimated 35,000 women affected each year by serious pregnancy-related complications. In response to this crisis, the United States has made improving maternal health—including maternal behavioral health—.

The crisis is particularly acute for Black women, Native women, and women in rural communities who experience the highest rates of deaths and illness from complications of labor or delivery, such as renal failure, eclampsia, heart failure, problems with anesthesia, sepsis, aneurysms, and more.

To successfully address these urgent challenges, healthcare organizations must have the ability to measure maternal morbidities and use their data for epidemiological surveillance, population health improvement, and research. State health departments, health insurance companies, policymakers, and others need reliable information about which complications are occurring, and how often.

With that need in mind, ´óÏóÊÓƵis pleased to highlight , a new set of quality indicators available for analyzing trends in severe maternal morbidity. The tool from AHRQ’s program allows state organizations, payers, researchers, healthcare providers, and others to track maternal morbidity trends and develop population health improvement strategies and conduct epidemiological or research studies using administrative (billing or claims) data—an especially important option for groups that may lack access to detailed clinical data.

Collaborating With Federal Partners

The MHI software, now in its testing phase, is an important example of what can be accomplished when federal agencies and external stakeholders work together.

In 2021-2022, ´óÏóÊÓƵcollaborated with the Health Services and Resource Administration (HRSA) and the Centers for Disease Control (CDC) to make publicly available a state-level measure of severe maternal morbidity. The , available through AHRQ's , was an important step towards transparency on state-level rates throughout the United States.

With the goal of improving the severe maternal morbidity measure, earlier this year ´óÏóÊÓƵissued a seeking input from the public and stakeholders. Feedback was robust; 51 entities—local and state health officials, healthcare system leaders, hospital associations, researchers, professional organizations, and others—provided valuable insights about how to improve a claims-based measure of severe maternal morbidity.

Using all-payer billing data from HCUP, ´óÏóÊÓƵassessed several refinements to definitions of maternal health complications during labor and delivery, such as coagulopathy and renal failure. A federal interagency workgroup, including subject matter experts from CDC, HRSA, and the Office of the Assistant Secretary for Health Office of Women’s Health, provided further feedback. ´óÏóÊÓƵalso coordinated efforts with the Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality.

Launching a Tool To Measure Maternal Health Indicators

AHRQ's new beta software to examine Maternal Health Indicators, launched in September, is intended to provide an easily accessible tool to construct area-level measures of severe maternal morbidity using readily available administrative claims data. The software allows states and other organizations to understand area-level rates of severe maternal morbidity overall and by demographic characteristics, including race/ethnicity. Organizations may also compare their rates to nationwide benchmarks. However, the software is not intended for use for comparisons across hospitals or in value-based payment programs. The measure builds on the algorithm previously used by the CDC, HRSA, and AHRQ.

Moving Maternal Health Measurement Forward

Going forward, ´óÏóÊÓƵwill collect feedback from MHI software users and continue to test new refinements in collaboration with federal agencies. Future updates to the software may include measures of post-discharge outcomes, such as extending the surveillance period for health conditions over 3, 6, and 12 months. ´óÏóÊÓƵalso plans to explore measures of mental health and substance abuse in prenatal and postnatal periods.

´óÏóÊÓƵis proud to contribute to ongoing federal efforts to improve maternal health. Other recent contributions by ´óÏóÊÓƵinclude an and examining trends in severe maternal morbidity complications, as well as a toolkit to support efforts by labor and delivery units to improve perinatal safety.

We encourage you to learn more about the as well as additional software modules and measures offered by AHRQ's . ´óÏóÊÓƵwelcomes your feedback at QIsupport@ahrq.hhs.gov.

Dr. Schott is the health statistician, and Dr. George is program lead, for the ´óÏóÊÓƵQuality Indicators Program in AHRQ’s Center for Quality Improvement and Patient Safety.

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