Lactation education

Tricare will cover Doulas, lactation consultants for some from January 1

Moms-to-be using Tricare in the United States will have access to the services of a doula and/or lactation consultant under a new program rolled out by the Department of Defense in 2022.

The Pentagon announced Friday that it plans to launch a five-year pilot project starting Jan. 1 to examine whether these birthing and breastfeeding consultants can help improve health outcomes for new moms and babies in the Tricare program. .

But the pilot will only be for those using the Tricare health program at civilian facilities in the United States and won’t be available overseas until January 1, 2025.

The program, created earlier this year in the Defense Policy Act of 2021, “will study the impact of the addition of these providers and services on the cost, quality of care and maternal and fetal outcomes for the population Tricare”. according to an announcement Friday in the Federal Register.

According to the Pentagon, the military health system has significantly lower maternal and infant mortality rates than the general population of the United States: 7.4 maternal deaths per 100,000 births, or 42% less than in the general population. , and 2.51 newborn deaths per 1,000 live. births, i.e. 62% less. But it “continues to work actively to reduce child and maternal mortality,” officials noted.

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The Federal Register notice does not say whether telehealth visits would be covered by the new program. During the COVID-19 pandemic, many hospitals barred doulas from delivery rooms.

The new program will separately study the impact of doula assistance and breastfeeding support, weighing their impact to determine whether the two should become a permanent benefit under Tricare, according to the DoD.

“The three months immediately following birth, sometimes referred to as the “fourth trimester,” account for more than half (52%) of pregnancy-related deaths in the United States…Doulas and lactation consultants and counselors provide services during pregnancy and the critical fourth trimester, which may impact outcomes for both the birthing parent and the baby,” wrote Aaron Siegel, Federal Register alternate liaison officer for the Department of Defense.

Labor doulas are non-medical professionals trained to provide counseling and support to birthing mothers before, during, and after the labor and birth process.

Under the program, Tricare will cover up to six prenatal and postpartum visits by a certified labor doula, as well as assistance throughout a vaginal or caesarean delivery, whether it occurs in a hospital, birthing center or at home under the supervision of a Tricare approved provider.

The program will only cover experienced doulas certified by one of the following organizations: BirthWorks International; Doulas from North America International; Professional Association for Childbirth and Postpartum; International Association for Childbirth Education; and toLabor.

Visits will be reimbursed at $46, while support during labor will be reimbursed at $690 for 2021, with both figures to be adjusted annually.

While Tricare has consistently supported new mums with lactation counseling through outpatient postpartum appointments and child health visits and has covered up to six lactation counseling sessions since 2015, this The latter program is underutilized, with only 5% of new moms using it in fiscal year 2020, according to military health officials.

The new program will expand provider eligibility, allowing non-medical personnel trained as consultants to participate.

It allows coverage for up to six lactation counseling sessions per birth, as well as group lactation classes and counseling sessions.

The pilot will cover lactation consultants who have certification from the International Board of Lactation Consultant Examiners or who are certified as an Advanced Consultant by the Academy of Lactation Policy and Practice.

The new benefit does not cover those seen in military treatment facilities, nor will it be available to those using the U.S. Family Health Plan or Continuing Health Care Benefits program.

DoD officials noted that some military hospitals have lactation consultants on staff, and while there are no doulas at these hospitals, many do”[military treatment facilities] allow recipients to bring a doula with them during labor, whether that doula is volunteer, paid for by family, or reimbursed through another program.”

The new program will not be offered to Tricare recipients overseas until January 1, 2025. Officials said delaying the rollout outside the United States “will reduce the administrative burden of demonstrating without significantly impacting the results of the demonstration.

The five-year pilot project is expected to cost $51.16 million, with an additional $4.3 million cost for analysis.

Senate Democrats Kirsten Gillibrand of New York and Richard Blumenthal of Connecticut initially sponsored the legislation, saying they wanted to help service members and service spouses who may give birth alone following deployment or training and who are estranged from family and friends.

“Military mothers, whether they are military themselves or partners of those who serve, are at higher risk of stress and isolation during their pregnancies, and they are more likely to give birth alone – all factors that make the particularly important access to the doula,” Blumenthal said when introducing the legislation.

Legislation containing the provision became law on January 1, 2021, following a veto by then-President Donald Trump.

— Patricia Kime can be contacted at [email protected]. Follow her on Twitter @patriciakime.

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