Implementing and Evaluating a Telephone-Based Centralized Maternity Care Coordination Program for Pregnant Veterans in the Department of Veterans Affairs

Selection of Higher Risk Pregnancies into Veterans Health Administration Programs: Discoveries from Linked Department of Veterans Affairs and California Birth Data

“…Veterans are confirmed to be a higher risk obstetric population, with the VA covering an even higher risk subpopulation, and the fraction of Veterans using VA maternity coverage is now shown to rival the fraction relying on Medicaid for such benefits. As the VA disproportionately serves those with high mental and physical health needs, these findings reinforce the importance of current efforts (VA 2012; Katon et al 2017b;Mattocks et al 2017a) to coordinate on-site VA care with off-site maternity care, and…”

“…2017b; Mattocks et al. 2017a). Our findings highlight the importance of such efforts and reinforce prior calls (Mattocks ; Shivakumar, Anderson, and Surís ) to ensure that common mental health conditions among Veterans, such as depression and PTSD, receive appropriate ongoing treatment around pregnancy (including preconception counseling and during the susceptible period postpartum) and aspirations for an overarching system of maternity care coordination that spans VA providers and community‐based obstetrical providers.…”

“…2017b; Mattocks et al. 2017a) to coordinate on‐site VA care with off‐site maternity care, and suggest a need for more nuanced research and clinical attention to Veterans’ maternal and newborn outcomes.…”

“…Nearly all VA‐covered maternity care is provided as non‐VA services covered by the VA—that is, care provided by non‐VA community and/or academic obstetrical providers, but reimbursed by the VA (Mattocks et al. 2017a). Therefore, for a growing number of women Veterans, the VA has over a decade of experience acting as insurer for non‐VA maternity care.…”

“…In 2012, the VA Office of Women's Health Services issued a Maternity Health Care and Coordination policy that mandated creation of a maternity care coordinator within each regional VA health care system to ensure appropriate care including screening and provision for mental health needs (VA 2012). Early efforts to evaluate implementation of this novel maternity care coordination role within the VA are ongoing and, appropriately, include significant focus on addressing mental and psychosocial needs in the antepartum and postpartum period (Katon et al 2017b;Mattocks et al 2017a). Our findings highlight the importance of such efforts and reinforce prior calls (Mattocks 2015; Shivakumar, Anderson, and Sur ıs 2015) to ensure that common mental health conditions among Veterans, such as depression and PTSD, receive appropriate ongoing treatment around pregnancy (including preconception counseling and during the susceptible period postpartum) and aspirations for an overarching system of maternity care coordination that spans VA providers and community-based obstetrical providers.…”