Maternal Opioid Misuse Model

Centers for Medicare and Medicaid Services (CMS) developed a Maternal Opioid Misuse (MOM) Model. This model was created to fight the ongoing opioid use disorder among pregnant and postpartum Medicaid clients.

In December 2019, the Colorado Department of Health Care Policy & Financing was awarded the MOM grant to bring this model to Health First Colorado (Colorado's Medicaid Program). In the last decade, a disturbing trend has emerged in Colorado. In place of postpartum hemorrhage and eclampsia related deaths, behavioral health conditions are now the leading cause of maternal mortality. While Colorado's maternal population has been greatly impacted by the increase in maternal morbidity and mortality associated with behavioral health disorders, recent changes in the Colorado delivery system can make improving these outcomes more feasible. The new iteration of the Department's Accountable Care Collaborative aligns the administration of physical and behavioral health services under one entity -- the Regional Accountable Entity (RAE) -- to improve member health and reduce costs.

Given the unique needs and existing efforts in communities across Colorado, the Department’s proposed approach for the MOM model will support local providers while building statewide capacity to serve pregnant and parenting women with OUD and their infants. The Department will utilize a total budget of $4.6 million to provide two components of support for integrating care:

  1. regionally specific subgrants totaling up to $506,778 per site over four years for integrating SUD treatment into primary and obstetric care sites that are appropriate to their community; and
  2.  technical assistance to subgrantees through a learning collaborative model. Practice site subgrants comprise $3.55 million of the total budget with the remaining $1.05 million going towards administrative costs to support and monitor efforts statewide. Due to integrated care driving appropriate utilization of health care and decreasing deleterious outcomes that drive costs, the Department anticipates saving $1,295,888 over the five-year grant cycle for the model population, which includes eligible enrollees statewide.

Please see the links below to view additional information regarding this grant.

Maternal Opioid Misuse (MOM) Model Grant Stakeholder Engagement
Maternal Opioid Misuse Model Fact Sheet