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Doulas Share Their Experiences with Medicaid Doula Benefits in Their States

AcademyHealth’s Project DREAM interviewed doulas in six different states about their experiences working with people enrolled in Medicaid. Doulas share that although coverage for these services is important, there are still hurdles to ensuring Medicaid reimbursement is equitable and sustainable for doulas and patients.

Study Reveals Doulas’ Experiences with Six State Medicaid Doula Benefits

Study Reveals Doulas’ Experiences with Six State Medicaid Doula Benefits

This study snapshot outlines findings from Patient-Centered Outcomes Research Institute (PCORI)-funded research examining doulas’ experiences of state-based Medicaid reimbursement programs and what facilitators and barriers they face when serving Medicaid patients through these programs.

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Doula care, or the emotional, informational, physical, and advocacy support provided to people during pregnancy, labor, childbirth, and postpartum, is cost effective and improves maternal and child health, especially for Medicaid enrollees. Many states reimburse doula care through Medicaid, but coverage varies by state, and it is unclear how doulas have experienced these Medicaid programmatic changes.

Team members from AcademyHealth’s Project DREAM sought to better understand doulas’ experiences with Medicaid doula benefits, or lack thereof, in 6 states through focus groups with 58 doulas.  

Doula participants shared that:

  • It is particularly important for Medicaid enrollees to have access to doula care because of the challenges they face related to health-related social needs.
  • Medicaid registration and reimbursement processes are so cumbersome, and the reimbursement rates so low, that many doulas forgo registering as a Medicaid provider altogether.
  • Solutions that have been successful include engaging doulas in the policy-making process, scholarships for doulas to become trained and certified, training on the required Medicaid processes, and ongoing mentorship for doulas.

Find the full paper, “A lot of hoops … to jump through”: Doula experiences serving Medicaid clients in states with and without Medicaid doula coverage, here.

Learn more about Project DREAM here.

Author

Elizabeth A. Mosley, Ph.D., M.P.H.

Assistant Professor - University of Pittsburgh School of Medicine

Dr. Elizabeth A. Mosley, Ph.D., M.P.H. is an Assistant Professor at the University of Pittsburgh School of Med... Read Bio