Bill Overview
Title: Connected Maternal Online Monitoring Act
Description: This bill requires the Centers for Medicare & Medicaid Services to report, and provide resources for states, on coverage of remote physiologic devices and related services (e.g., blood glucose monitors) under Medicaid, so as to improve maternal and child health outcomes for pregnant and postpartum women.
Sponsors: Rep. Frankel, Lois [D-FL-21]
Target Audience
Population: Pregnant and postpartum women
Estimated Size: 2700000
- The bill is focused on improving maternal and child health outcomes, specifically targeting pregnant and postpartum women.
- The use of remote physiologic devices and services (such as blood glucose monitors) is promoted, which is relevant to pregnant and postpartum women requiring ongoing health metrics tracking.
- The legislation involves the Centers for Medicare & Medicaid Services, indicating it targets populations that utilize Medicaid.
- Globally, the target is pregnant and postpartum women who might benefit from enhanced perinatal care through technological means.
Reasoning
- The policy targets pregnant and postpartum women who are Medicaid beneficiaries, with an estimated 2.7 million potentially affected annually.
- Not every Medicaid-eligible pregnant or postpartum woman will need or benefit from remote physiological monitoring equipment.
- Cost constraints limit the program's reach and intensity of service; therefore, some individuals in need may not receive the devices or services.
- The potential impact varies with socioeconomic status, existing health issues, and technological literacy.
- There are individuals in the population not eligible for Medicaid, who will not be directly impacted by the policy.
Simulated Interviews
Warehouse worker (Atlanta, GA)
Age: 28 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- I think having a device to monitor my blood pressure and glucose has been a lifesaver, especially with no close clinics nearby.
- It's reassuring knowing I can check in with my doctor without having to take time off work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Stay-at-home mom (Rural Tennessee)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I worry about my health all the time because the hospital is so far away.
- If I can get a monitor sent home, that would make a world of difference during this pregnancy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
Graduate student (New York, NY)
Age: 24 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 12/20
Statement of Opinion:
- I'm okay with going to the clinic, but a home monitor could be nice for peace of mind.
- If I didn't need to worry about appointments as much, I could focus more on my studies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Retail worker (Chicago, IL)
Age: 30 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 11/20
Statement of Opinion:
- With my health conditions, I feel constant anxiety about going to the ER.
- I hope this policy will cover devices that help manage my condition better from home.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Software engineer (San Francisco, CA)
Age: 40 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- I probably won't be using this program since I have access to health facilities and resources.
- I see the benefit for those who may not have the same access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
Unemployed (Dallas, TX)
Age: 19 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 4.0 years
Commonness: 6/20
Statement of Opinion:
- Getting a device could make it easier to manage my health without needing help to get to the clinic.
- Anything that comes to me free is a big help right now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 2 |
| Year 5 | 5 | 2 |
| Year 10 | 4 | 2 |
| Year 20 | 4 | 1 |
Elementary school teacher (Phoenix, AZ)
Age: 33 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 15/20
Statement of Opinion:
- I am open to using a home monitoring system if it saves me time, but I feel fairly healthy overall.
- I think it's good for others who might really need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Barista (Houston, TX)
Age: 27 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 9/20
Statement of Opinion:
- Mobile health devices should be a part of our healthcare; it prevents unnecessary stress and runs to doctors.
- I think this would really help me manage my time between work and being a mom.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
Part-time nurse (Miami, FL)
Age: 39 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I think this policy could streamline my access to health advice without needing to take time off my shifts.
- It will be helpful to have some of these devices without extra charges.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Graphic designer (Seattle, WA)
Age: 29 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 14/20
Statement of Opinion:
- It sounds convenient to have remote monitoring, especially when deadlines mean I can't easily get away.
- Knowing I have this option definitely brings some relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $540000000 (Low: $486000000, High: $594000000)
Year 2: $540000000 (Low: $486000000, High: $594000000)
Year 3: $540000000 (Low: $486000000, High: $594000000)
Year 5: $540000000 (Low: $486000000, High: $594000000)
Year 10: $540000000 (Low: $486000000, High: $594000000)
Year 100: $540000000 (Low: $486000000, High: $594000000)
Key Considerations
- Accurate estimation hinges on the speed and extent to which states adopt coverage for these devices and services under Medicaid.
- Administrative expenses could fluctuate based on the complexity of integrating these new technologies into existing Medicaid frameworks.
- Evaluation of actual vs. projected health outcomes and the associated healthcare utilization changes.