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Hello, everyone. This is Liz Caslow with the

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Becker's Payer Issues podcast.

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I'm thrilled today to be joined by doctor

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Cynthia Brown, medical director and clinical lead for

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women's health at Elevance Health. Thanks so much

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for chatting with us today. And

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just to get started, I would love to

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hear a bit more about your career background.

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And could you give us a bit of

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an overview on your current role at Elevance?

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Sure. Thanks, Liz, and thanks for having me

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on your program today.

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So, as you said, my name is Cynthia

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Brown.

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I am a board certified

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obstetrician and gynecologist.

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I've practiced clinically for twenty years prior to

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coming to Elavance,

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and now I serve as the medical director,

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for women's health

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at Elavance Health.

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Basically, my purpose here is to advocate for

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women. So I focus on impacting outcomes,

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addressing inequities, and overall ex improving the experiences

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for women

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across all stages of their health journey and

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really with a special

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special emphasis on maternal health.

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So

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my role is really one of looking for

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opportunities for improvement.

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You know, I identify drivers and barriers to

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that improvement and then

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collaborate with lots of people,

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in order to put all those pieces together

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and find solutions that work for our members.

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So I I collaborate with our clinical teams

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in all lines of business, our local health

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plans,

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our public policy institute,

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and then our community based partners as well.

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And we evaluate the evidence, design new programs,

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and we look to scale solutions that improve

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member experience and outcomes,

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like doula care that we're talking about today.

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Yeah. I'm really excited to talk about this

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solution with you. So just for context, for

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the first time, some Ellevance Health affiliated employer

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health plans will include doula services.

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So can you elaborate

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on that,

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expansion? Because, originally,

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there was some Medicaid plans. There were some

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Medicaid plans that had doulas for several years,

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but how did that grow to these employer

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plans?

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Yeah. Absolutely.

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So as we saw maternal health complications rising

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nationally,

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we knew that we needed solutions,

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that not only improved clinical outcomes but strengthened

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the care experience for our pregnant women.

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And when we looked across that evidence, doula

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care consistently

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surfaced as one of our most promising approaches.

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So doulas, just to kinda level set, are

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trained,

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nonclinical,

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people

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who provide emotional,

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physical, and educational support during pregnancy, childbirth,

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and the postpartum period.

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They are not clinicians. They don't do deliveries.

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They really are,

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a social support.

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And social support is one of the most

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consistent predictors

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of better health outcomes.

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And it's one of the strongest protective factors,

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across the entire prenatal period. So when we

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have good support,

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we have less stress. We have less stress.

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We have better mental and physical

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health.

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So our public policy institute conducted some research

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studies, and the results showed that women who

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had doula support

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were more likely to carry to full term.

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They had fewer birth weight infants.

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They had reduced NICU admissions.

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They had less c sections, and then they

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had better postpartum mental health. And all of

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these outcomes were meaningful from both, obviously, a

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clinical perspective, but also for the member experience.

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So,

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typically, when we implement programs, we pilot them.

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And we usually pilot them in the groups

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where there's the greatest need or we can,

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you know, make the most impact. So we

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started in Medicaid,

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and our research there showed our experience there,

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showed that members receiving doula support

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navigate their pregnancy with better confidence.

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They have better understanding and emotional well-being, and

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they had better birthing outcomes.

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So then we had to take the time

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to build the infrastructure,

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that's needed to really bring doulas into our

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network at scale. So this meant, you know,

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things like establishing

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credentialing pathways, developing reimbursement models across all our

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states,

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partnering with doula organizations

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to grow the workforce that reflects the communities

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we serve. But as a result, in 2025,

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members in select,

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employer sponsored health plans can now search for

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and select doulas

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just like they would any other in network

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provider.

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So in the same way that you would

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look for a cardiologist that met your needs

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or a dermatologist, you can now search for

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a doula who addresses the needs of your

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whole family during pregnancy delivery and the postpartum

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time.

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That's great to hear. And I wanna follow-up

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on some of those outcomes in just a

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moment, but racial disparities are particularly prevalent with

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maternal health outcomes. So can you talk about

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how doulas may address these gaps?

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Absolutely.

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You know, we know that maternal health challenges

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affect women across all backgrounds,

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and even women with higher income or advanced

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education

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can face poor experiences

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and outcomes

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simply because they don't always feel heard and

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supported.

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So for many families, doula care has been

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out of reach because it wasn't traditionally covered

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by insurance.

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Expanding this access helps remove that barrier, and

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it gives women more women the support that

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they deserve.

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Families who work with doulas often have smoother

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experiences.

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They have less unnecessary interventions.

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They have more success with breastfeeding.

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They have better emotional well-being.

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And this is

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even stronger. These benefits are even stronger and

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well noted in underserved communities,

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especially when families are paired with community based

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doulas who understand their culture

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and their language and their lived experience.

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So this shared understanding then builds trust. And

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when women feel safe and understood, they're more

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likely to speak up about their needs and

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their concerns, and this is really the key

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to preventing

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complications.

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So at the heart of it, really, doulas

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create a more personal,

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kinda culturally aligned, and supportive experience for all

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moms,

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and that's really a pretty powerful way to

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address long standing gaps in maternal health care.

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Yeah.

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So can you talk a little bit about

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what sorts of long term savings,

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these investments in doulas could lead to for

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Ellevance?

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Yes. I'm glad you asked that. You know,

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it really starts with the member experience.

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When women feel supported,

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they engage earlier. They ask more questions of

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their providers.

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They are more likely to adhere to their

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care plan, and then they get help before

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these small issues turn into big complications.

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You know, mental health and substance use are

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two of the leading causes of postpartum

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maternal deaths in this country. And as I

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said before,

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social support

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is one of the strongest

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protective factors across pregnancy and postpartum in its

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ability to reduce stress and to improve mental

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health. So doulas provide this as well.

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They also you know, as I've said before,

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those who have doula care have reduced c

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sections.

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They have less preterm births. They have less

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NICU admissions.

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And these are all events that have really

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significant cost. So by having doulas involved, you

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know, that's creating meaningful long term value.

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So,

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again, overall, what matters most,

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is really that doulas are creating safer pregnancies,

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healthier babies, and a more positive empowering experience

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for moms.

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So I wanted to wrap this up by

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getting some of your final thoughts and advice

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for other industry leaders as they focus on

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maternal health,

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and if they're considering possibly expanding to include

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doula coverage.

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My advice for other industry leaders is to

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definitely consider doula coverage. You know, we we

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advocate for doula care at Elevance Health because

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it works. You know, we've done the research.

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We've run the pilot programs,

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and it's

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clear that doulas help women

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access the care that they need, and the

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result is healthier, safer pregnancies and deliveries.

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You know, pregnancy is such an incredibly

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vulnerable and stressful time for people,

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And members just wanna feel heard,

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supported, and guided,

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not just in the delivery room, but really

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throughout the entire journey.

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So doulas really help provide that continuous presence.

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And by helping people navigate, you know, what

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can be a complicated health care system, it

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helps ease anxieties, it empowers them, and it

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basically just improves,

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outcomes and is a great you know, expanding

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access to them is really one of the

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opportunities all of us have in this industry

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to elevate both the member experience

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and health outcomes for moms and babies.

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Well, thank you so much, doctor Brown. We

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really appreciate having you.

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And to our listeners, if you'd like to

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listen to more podcasts from Becker's Healthcare, you

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can visit beckers hospital review dot com. Thank

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you. Thanks, Liz.