2024 State Report Cards Methodology & Measures

2024 Maternal Mental Health State Report Cards

Methodology and Measures

Overview 

The 2024 MMH report cards include 18 measures across 3 domains:

1. Providers and Programs 
2. Screening Requirements and Reimbursement
3. Insurance Coverage and Payment

What changed in 2024? 

Three new measures have been added in 2024:

• Measure #7: State has a Perinatal Quality Collaborative (PQC) that has prioritized MMH
• Measure #8: State is a top performer on the “prenatal depression screening” HEDIS measure (Commercial insurance and/or Medicaid)
• Measure #9: State is a top performer on the “postpartum depression screening” HEDIS measure (Commercial insurance and/or Medicaid)

One measure was retired, and one measure was paused:

• Former Measure #7 (State mandated MMH screening) Measure replaced with the new HEDIS measures, as a more direct measure of MMH screening.
• Former Measure #8 (State Medicaid reimburses OBs for MMH screening) Measure “paused” due to data being unavailable in 2024. Points provided in 2023, remained in place in 2024.

Five measures were modified slightly:

• Measure #1 and Measure #2 (MMH provider and prescriber measures): In 2024, an additional data source was added, the Marce of North America’s list of Reproductive Mental Health Academic Programs. Additionally, Measure #1’s structure changed slightly. In 2023, Measure #1 captured all PMH-Cs (including prescribers); in 2024, prescribers are included only in Measure #2.

• Measure #17, and 18 (private insurer claims measures): In 2024, three additional CPT codes were added to claims analysis.

2024 Measures by Domain

Domain 1: Providers and Programs

1. State meets ratio of non-prescriber MMH providers to perinatal population (5 per 1,000 births) 

• Item: The state has at least 5 non-prescriber MMH providers for every 1,000 births. (Providers include Perinatal Mental Health Certified (PMH-C) providers, as well as those providers trained for every 1,000 births. 
• Dataset: PSI PMH-C Directory and the Marce of North America’s list of Reproductive Mental Health Academic Programs 
• Scoring: 3 points for states that meet the ratio

2. State meets ratio of MMH prescribers to perinatal population (1 per 5,000 births) 

• Item: The state has at least 1 mental health prescriber with specialized perinatal training for every 5,000 births. 
• Dataset: PSI Prescriber Directory and the Marce of North America’s list of Reproductive Mental Health Academic Programs  
• Note: This measure does not include OB-GYNs.
• Scoring: 3 points for states that meet the ratio

3. State has at least one inpatient MMH treatment program 

• Item: The state has an inpatient MMH program(s)
• Dataset: Postpartum Support International list of inpatient programs 
• Scoring: 1 point per program, capped at 3 points per state

4. State has at least one outpatient intensive or partial hospitalization treatment MMH program

• Item: The state has an outpatient MMH program(s)
• Dataset: Postpartum Support International list of outpatient programs 
• Scoring: 1 point per program, capped at 3 points per state

5. State has or has/has had a state-sanctioned MMH Task Force or Commission 

• Item: State has or has had formed a Task Force or Commission to issue a strategic plan on maternal mental health
• Dataset: 2024 MMH Task Force Tracker
• Scoring: 3 points if state has a Task Force or Commission

6. State meets ratio of CBOs providing MMH direct services to perinatal population (at least 1 per 50,000 births)  

• Item: State has at least 1 CBO providing MMH services per 50,000 births
• Dataset: Policy Center for Maternal Mental Health’s Nonprofit Nation website.
• Scoring: If state meets ratio of 1 CBO per 50,000 births, state receives 1 point per CBO, capped at 3 points per state.
• Note: This measure remains preliminary, with low-reliability. Additional CBOs can be submitted to the Policy Center for Maternal Mental Health’s Nonprofit Nation website.

7. State has a Perinatal Quality Collaborative (PQC) that has prioritized MMH

• Item: State PQC has named MMH as a priority 
• Dataset: The National Network of Perinatal Quality Collaboratives
• Scoring: If state PQC has made MMH a priority, state receives 1 point 
• Note: This is a new measure for 2024. 

Domain 2: Screening Requirements and Reimbursement  

8. State is a top performer on the HEDIS “prenatal depression screening” measure (among commercial insurance and/or Medicaid) 

• Item: State HEDIS prenatal depression screening measure scores are >=10%
• Dataset: HEDIS State Reporting dataset for RY 2022/MY 2023 (tab 1)
• Scoring: 4 points if HEDIS measures are >=10%. 
• Note: This is a new measure for 2024. 

9. State is a top performer on the HEDIS “postpartum depression screening” measure (among commercial insurance and/or Medicaid)

• Item: State HEDIS postpartum depression screening measure scores are >=10%
• Dataset: HEDIS State Reporting dataset for RY 2022/MY 2023 (tab 2)
• Scoring: 4 points if HEDIS measures are >=10%. 
• Note: This is a new measure for 2024. 

10. State Medicaid requires MCOs to report “prenatal depression screening” HEDIS measure 

• Item: State Medicaid agency requires reporting of HEDIS PND-E measure
• Dataset: NASHP State Use of Behavioral Health Performance Measures in Medicaid Managed Care
• Scoring: 2 points if measure collected, 3 points if measure used for payment
• Note: Data was not refreshed by NASHP in 2023. Data/points were held constant in 2023. Some state Medicaid agencies may now be requiring MCOs to report this HEDIS measure that are not reflected in the data set.

11. State Medicaid requires MCOs to report“postpartum depression screening” HEDIS measure

• Item: State Medicaid agency requires reporting of HEDIS PDS-E measure
• Dataset: NASHP State Use of Behavioral Health Performance Measures in Medicaid Managed Care
• Scoring: 2 points if measure collected, 3 points if measure used for payment
• Note: Data was not refreshed by NASHP in 2023. Data/points were held constant in 2023. Some state Medicaid agencies may now be requiring MCOs to report this HEDIS measure that are not reflected in the data set.

12. Obstetric providers submit claims to private insurers for prenatal MMH screening (among at least 1% of prenatal patients)

• Item: % those who are privately insured and pregnant whose provider billed for mental health screening (any provider) 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database. Procedures codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for prenatal MMH screening: 1-3% = 0.5 points, 3%-14% = 1 point, 15% or higher = 3 points. States with reported OB screening > 1% receive 1 extra point. 
• Note: Providers include nurse practitioners, physician assistants, OB-GYNs, family practice providers, and midwives.
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

13. Obstetric providers submit claims to private insurers for postpartum MMH screening (among at least 1% of postpartum patients)

• Item: % persons who are privately insured and in the postpartum period whose provider billed for mental health screening (any provider) 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database. Procedures codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for postpartum MMH screening: 1-3% = 0.5 points, 3%-14% = 1 point, 15% or higher = 3 points. 
• Note: Providers include nurse practitioners, physician assistants, OB-GYNs, family practice providers, and midwives.
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

Domain 3: Insurance Coverage and Treatment Payment

14. State expanded Medicaid 

• Item: The state has adopted Medicaid expansion
• Dataset: Kaiser Family Foundation Medicaid Expansion Tracker
• Scoring: 1 point if the state had expanded Medicaid 

15. State extended Medicaid coverage to one year postpartum  

• Item: State implemented or is planning to implement postpartum coverage for Medicaid beneficiaries to 12 months postpartum
• Dataset: Kaiser Family Foundation Postpartum Medicaid Extension Tracker
• Scoring: 2 points if the state has extended Medicaid coverage to one year postpartum

16. State requires health plans to develop an MMH quality management program

• Item: The state mandates that all health plans develop a maternal mental health quality management program 
• Dataset: MMH Quality Improvement Program Tracker
• Scoring: 3 points if the state mandates MMH quality management program 

17. Providers submit claims to private insurers for prenatal MMH treatment (among at least 10% of prenatal patients)

• Item: % persons who are privately insured and pregnant whose provider billed for mental health treatment (any provider) 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database. Procedures codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for prenatal mental health treatment: 10%-14% = 1 point, 15% or higher = 3 points
• Note: For this measure, providers include psychiatrists, psychiatric nurses, psychologists, behavioral health providers, registered nurses, nurse practitioners, physician assistants, OB-GYNs, midwives, and family practice. 
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

18. Providers submit claims to private insurers for postpartum MMH treatment (among at least 10% of postpartum patients)

• Item: % persons who are privately insured in the postpartum period whose provider billed for mental health treatment (any provider) 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database. Procedures codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for postpartum mental health treatment: 10%-14% = 1 point, 15% or higher = 3 points)
• Note: For this measure, providers include psychiatrists, psychiatric nurses, psychologists, behavioral health providers, registered nurses, nurse practitioners, physician assistants, OB-GYNs, midwives, and family practice. (Note: “MMH treatment” among non-behavioral health providers is provided through evaluation & management.) 
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

For more information regarding data or methodology, please email [email protected].