Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast. Very thrilled today to
be joined by doctor Rhonda Randall, who serves
as the chief medical officer for UnitedHealthcare's
employer and individual business. Doctor Randall, thank you
so much for taking the time to be
with me on the podcast today. Thank you
for having me. Absolutely. It's it's a pleasure.
And before we dive into everything we wanna
talk with you about, a special announcement from
United. I'm wondering if you could first tell
us a little bit more about yourself
and give us an overview of your role
at UnitedHealthcare.
Yeah. Thank you for asking that. I'm a
primary care physician and have been working with
UnitedHealthcare for over two decades, focused on helping
people live healthier lives and helping the health
system work better for everyone.
That, includes
our,
members who are going through
health care journeys, including those that are preventative
care and,
avoiding when we can
the escalation of a chronic disease and supporting
members
when they do have a significant health care
journey.
Wonderful. Well, Rhonda, thank you so much for
taking the time to sit down and chat
with us today. We're here today to talk
with you about some exciting news from UnitedHealthcare.
The company has announced a national expansion of
its doula offering.
And so throughout 2026,
availability is going to continue to expand to
additional employer groups. And by 01/01/2027,
about 7,200,000
members may have access to,
this expanded coverage if it's part of their
employer's health plan.
So, Rhonda, to start us off, for our
listeners who might not be familiar,
what exactly does a doula do, and what's
the significance of a major insurer like UnitedHealthcare
expanding commercial coverage around this?
Well, a doula is a non licensed,
non clinically trained advocate
who provides emotional, physical, and educational support, which
can be throughout your pregnancy,
during childbirth, and labor, and also in the
postpartum period.
And they don't deliver babies or provide medical
care like a physician or a midwife may.
They don't replace your doctor, but they are
a very valuable part of that broader care
team. And we're we've learned more and more
about that in medical literature over the last
several years that when a doula is working
alongside
those other clinicians who are part of your
care team, it can help you feel more
informed. It can help you feel more supported,
more heard throughout your care journey.
And there's good evidence now that there is
improvement
in preterm births, c section rates going down
by more than fifty two percent,
less babies need to be admitted to the
NICU when there's lower preterm births,
decreases of postpartum
depression and postpartum
anxiety by fifty seven percent when a doula
is part of the care team. So,
we see this as very valuable part of
that helping people live healthier lives.
And this is something that UnitedHealthcare,
is doing now and in 2027
will be doing at a very significant scale.
And I do wanna dive in a bit,
in just a bit, in terms of some
of the the clinical importance here, but I'm
also wondering what you were hearing from employers
themselves in regards to the demand for something
like this.
Employers are particularly
interested in making sure that their
employees and their beneficiaries
have better health experiences,
better health journeys.
Childbirth is one of the most common,
health care events that an employer
will
pay claims for their employee over the course
of their employment.
And employers are very focused on the same
things that we see in our nation with
high rates of maternal morbidity and mortality.
And the fact that, unfortunately,
that is get has been getting worse over
the last
decade or more in The United States. And
we see when we compare
US to other developed and high income nations,
our rates of maternal morbidity and mortality
are often some of the worst in the
world.
So that affects
employers
as well as it does government programs like
Medicaid, for example.
Absolutely.
It makes sense. And and when we're thinking
about
tackling this this national issue,
what does the latest clinical research say about
the importance of expanding this kind of coverage?
Yeah. So there has been, again, more and
more published,
literature in well respected
medical journals,
like Lancet publications,
for example,
that doulas
do have a reduction in preterm births, a
reduction in c section rates, a reduction in
NICU admissions, a reduction in postpartum
anxiety and depression. And all of these are
very meaningful
measures,
in not only outcomes, but also for employers'
health care costs.
Certainly. So this is expected to improve health
outcomes in this space. And I wonder beyond
the clinical case, Rhonda, is there a business
case here to,
do doulas ultimately save the system and and
employers money?
Well, they take a whole person approach to
care.
And I'm an osteopathic physician, so
team based care and whole person approach to
care really does matter. There's very, very strong
evidence,
in in every area that you look that
whole person approach to care and team based
care
provides that type of not only informational support,
but physical and emotional support.
And so we're seeing that
that advocacy, that coaching component
that comes with the doula, the support
that you can get during the
pregnancy, during that labor and delivery
time frame and postpartum as well,
which may include
your recovery from
labor and delivery and also
the support you need to care for your
newborn.
So,
this is a very important journey and evolution
to take something that,
we've been watching very carefully that we have
been doing with select benefit plans and in
select markets
and now
scaling it, in a way that only UnitedHealthcare
can.
No. Absolutely. And it's been fascinating to see
the wider industry,
really begin to to latch onto this idea
and roll it out like we are seeing
UnitedHealthcare
do this year.
Rhonda, how do you see doulas
fitting into broader care teams alongside OBs, alongside
midwives? How does this all fit together?
Yeah. Let's start with this. You know, there's
there's always,
a concern when you enter a new profession
into a care team.
You know, is there variation?
Right? Are
is there consistency
in the way that those
paraprofessionals
are trained?
And is there clear role definition? And do
we all understand
what our role in that team is? And,
over the last few years, there have been
an increase in training and certificate programs for
doulas, and that has improved their focus on
medical ethics,
boundaries,
collaboration
with physicians and midwives.
And that has really improved the way that
doulas are integrating now into maternity care instead
of being a separate stand alone industry.
Absolutely. And I know it's been interesting on
our side of things. We've been seeing a
lot of state Medicaid programs really roll out
coverage in this space as well. But before
we go, doctor Rendell, is there anything else
that we're missing on this topic or any
other final bits of advice that you would
share
with, other health plan colleagues around the country
looking at similar policies, looking at rolling out,
similar coverage in the doula space?
Two things. So
UnitedHealthcare,
through our philanthropic arm, the UnitedHealth Foundation,
has been also focused on
the concerns that we have with rising rates
of maternal morbidity and mortality in The United
States. And we've
our foundation has been very focused on building
that stronger future for maternal and infant health,
And, that has included,
significant
funding in grants, $7,000,000
in maternal and infant grants, which of that
includes 1,000,000 dedicated to strengthening and diversifying the
dual workforce.
So that
research and philanthropic arm, very important for UnitedHealthcare
and UnitedHealth Group of the UnitedHealth Foundation as
well.
And then from an employer
perspective,
UnitedHealthcare
now will be the first to offer the
dual support in employer sponsored and commercial members
at this scale across
plans nationwide.
And so what differentiates us there is the
flexibility.
Depending on an employer's plan,
men most members are going to have a
choice of which doula they work with and
when they decide to use that doula support.
So they can choose any trained doula, whether
they're in or out of network. They can
choose when they're deciding to work with them,
whether it's during pregnancy, during labor and delivery,
or postpartum.
Wonderful. It's very exciting news, for the industry,
I think, overall and, of course, for for
the members that you serve, doctor Randall. So
I wanna thank you for taking the time
to chat with us about this and for
sharing your expertise with our audience. We really
appreciate it. Thank 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.