Hello, everyone. This is Liz Caslow with the
Becker's Payer Issues podcast.
I'm thrilled today to be joined by doctor
Cynthia Brown, medical director and clinical lead for
women's health at Elevance Health. Thanks so much
for chatting with us today. And
just to get started, I would love to
hear a bit more about your career background.
And could you give us a bit of
an overview on your current role at Elevance?
Sure. Thanks, Liz, and thanks for having me
on your program today.
So, as you said, my name is Cynthia
Brown.
I am a board certified
obstetrician and gynecologist.
I've practiced clinically for twenty years prior to
coming to Elavance,
and now I serve as the medical director,
for women's health
at Elavance Health.
Basically, my purpose here is to advocate for
women. So I focus on impacting outcomes,
addressing inequities, and overall ex improving the experiences
for women
across all stages of their health journey and
really with a special
special emphasis on maternal health.
So
my role is really one of looking for
opportunities for improvement.
You know, I identify drivers and barriers to
that improvement and then
collaborate with lots of people,
in order to put all those pieces together
and find solutions that work for our members.
So I I collaborate with our clinical teams
in all lines of business, our local health
plans,
our public policy institute,
and then our community based partners as well.
And we evaluate the evidence, design new programs,
and we look to scale solutions that improve
member experience and outcomes,
like doula care that we're talking about today.
Yeah. I'm really excited to talk about this
solution with you. So just for context, for
the first time, some Ellevance Health affiliated employer
health plans will include doula services.
So can you elaborate
on that,
expansion? Because, originally,
there was some Medicaid plans. There were some
Medicaid plans that had doulas for several years,
but how did that grow to these employer
plans?
Yeah. Absolutely.
So as we saw maternal health complications rising
nationally,
we knew that we needed solutions,
that not only improved clinical outcomes but strengthened
the care experience for our pregnant women.
And when we looked across that evidence, doula
care consistently
surfaced as one of our most promising approaches.
So doulas, just to kinda level set, are
trained,
nonclinical,
people
who provide emotional,
physical, and educational support during pregnancy, childbirth,
and the postpartum period.
They are not clinicians. They don't do deliveries.
They really are,
a social support.
And social support is one of the most
consistent predictors
of better health outcomes.
And it's one of the strongest protective factors,
across the entire prenatal period. So when we
have good support,
we have less stress. We have less stress.
We have better mental and physical
health.
So our public policy institute conducted some research
studies, and the results showed that women who
had doula support
were more likely to carry to full term.
They had fewer birth weight infants.
They had reduced NICU admissions.
They had less c sections, and then they
had better postpartum mental health. And all of
these outcomes were meaningful from both, obviously, a
clinical perspective, but also for the member experience.
So,
typically, when we implement programs, we pilot them.
And we usually pilot them in the groups
where there's the greatest need or we can,
you know, make the most impact. So we
started in Medicaid,
and our research there showed our experience there,
showed that members receiving doula support
navigate their pregnancy with better confidence.
They have better understanding and emotional well-being, and
they had better birthing outcomes.
So then we had to take the time
to build the infrastructure,
that's needed to really bring doulas into our
network at scale. So this meant, you know,
things like establishing
credentialing pathways, developing reimbursement models across all our
states,
partnering with doula organizations
to grow the workforce that reflects the communities
we serve. But as a result, in 2025,
members in select,
employer sponsored health plans can now search for
and select doulas
just like they would any other in network
provider.
So in the same way that you would
look for a cardiologist that met your needs
or a dermatologist, you can now search for
a doula who addresses the needs of your
whole family during pregnancy delivery and the postpartum
time.
That's great to hear. And I wanna follow-up
on some of those outcomes in just a
moment, but racial disparities are particularly prevalent with
maternal health outcomes. So can you talk about
how doulas may address these gaps?
Absolutely.
You know, we know that maternal health challenges
affect women across all backgrounds,
and even women with higher income or advanced
education
can face poor experiences
and outcomes
simply because they don't always feel heard and
supported.
So for many families, doula care has been
out of reach because it wasn't traditionally covered
by insurance.
Expanding this access helps remove that barrier, and
it gives women more women the support that
they deserve.
Families who work with doulas often have smoother
experiences.
They have less unnecessary interventions.
They have more success with breastfeeding.
They have better emotional well-being.
And this is
even stronger. These benefits are even stronger and
well noted in underserved communities,
especially when families are paired with community based
doulas who understand their culture
and their language and their lived experience.
So this shared understanding then builds trust. And
when women feel safe and understood, they're more
likely to speak up about their needs and
their concerns, and this is really the key
to preventing
complications.
So at the heart of it, really, doulas
create a more personal,
kinda culturally aligned, and supportive experience for all
moms,
and that's really a pretty powerful way to
address long standing gaps in maternal health care.
Yeah.
So can you talk a little bit about
what sorts of long term savings,
these investments in doulas could lead to for
Ellevance?
Yes. I'm glad you asked that. You know,
it really starts with the member experience.
When women feel supported,
they engage earlier. They ask more questions of
their providers.
They are more likely to adhere to their
care plan, and then they get help before
these small issues turn into big complications.
You know, mental health and substance use are
two of the leading causes of postpartum
maternal deaths in this country. And as I
said before,
social support
is one of the strongest
protective factors across pregnancy and postpartum in its
ability to reduce stress and to improve mental
health. So doulas provide this as well.
They also you know, as I've said before,
those who have doula care have reduced c
sections.
They have less preterm births. They have less
NICU admissions.
And these are all events that have really
significant cost. So by having doulas involved, you
know, that's creating meaningful long term value.
So,
again, overall, what matters most,
is really that doulas are creating safer pregnancies,
healthier babies, and a more positive empowering experience
for moms.
So I wanted to wrap this up by
getting some of your final thoughts and advice
for other industry leaders as they focus on
maternal health,
and if they're considering possibly expanding to include
doula coverage.
My advice for other industry leaders is to
definitely consider doula coverage. You know, we we
advocate for doula care at Elevance Health because
it works. You know, we've done the research.
We've run the pilot programs,
and it's
clear that doulas help women
access the care that they need, and the
result is healthier, safer pregnancies and deliveries.
You know, pregnancy is such an incredibly
vulnerable and stressful time for people,
And members just wanna feel heard,
supported, and guided,
not just in the delivery room, but really
throughout the entire journey.
So doulas really help provide that continuous presence.
And by helping people navigate, you know, what
can be a complicated health care system, it
helps ease anxieties, it empowers them, and it
basically just improves,
outcomes and is a great you know, expanding
access to them is really one of the
opportunities all of us have in this industry
to elevate both the member experience
and health outcomes for moms and babies.
Well, thank you so much, doctor Brown. We
really appreciate having you.
And to our listeners, if you'd like to
listen to more podcasts from Becker's Healthcare, you
can visit beckers hospital review dot com. Thank
you. Thanks, Liz.