BCBS Aspen Ideas Health Maternal


10 Steps to Advance Maternal Health Equity

Childbirth complications are unacceptably high among women of color—and the disparities have been widening. If the pandemic has taught us anything, it’s that we cannot solve system-wide problems in a vacuum—particularly when lives are at stake. We all need an all-in approach to create a better, more equitable system of health for all mothers. Presented by Blue Cross Blue Shield Association.

  • July 4th 2022

By Kim Keck, President and CEO, Blue Cross Blue Shield Association

The U.S. maternal death rate rose sharply in 2020 during the COVID-19 pandemic. And new Blue Cross Blue Shield (BCBS) data show that women of color are bearing a disproportionate burden of childbirth complications. For example, Black women face ~60% higher risk of severe complications than White women. More specifically, that’s 56% among women with commercial insurance and 67% among women with Medicaid.

Maternal health disparities span education level, socioeconomic status, age, geography – pointing to deeper-seated issues like underlying chronic conditions, racial inequities and bias within the health care system.

Creating a Better System of Health

We know 80% of our health is influenced by social determinants—or the things that happen outside of a doctor’s office, like access to transportation, fresh food, and safe living and working environments.

BCBS companies have been working to address some of these issues.

  • Blue Cross and Blue Shield of Minnesota is working to identify mothers and families who may not have access to nutritious food, then delivering healthy food to homes.
  • CareFirst BlueCross BlueShield has been involved with B’more for Healthy Babies for more than a decade, working to improve access to health resources among pregnant women, knocking on doors and providing support to mothers and babies in their homes.
  • Blue Cross and Blue Shield of Rhode Island is making it easier for mothers to get access to postpartum care when they bring their infants for follow-up visits, removing transportation barriers and need for childcare.

While these individual programs are critical addressing the root causes of health disparities, they are not enough. To help make a measurable difference in the health and well-being of women and babies we must move beyond creating a better health care system to build a “better system of health” that is equitable—for everyone.

That’s why in 2021, the Blue Cross Blue Shield Association set a bold goal to reduce racial disparities in maternal health by 50% in five years.

Ten Actions to Advance Maternal Health Equity

Guided by the actions underway by BCBS companies, we identified 10 tangible steps organizations can adopt to address maternal health disparities and help create a better system of health for moms and babies.

One of the ways BCBS companies are carrying out these actions is by partnering with the March of Dimes and other local organizations to offer implicit bias and education training – with the possibility of reaching the nearly 1.7 million providers in BCBS networks. Providing access to cultural humility and implicit bias training can help those involved in patient care to recognize their own biases, as well as address systemic bias that exists at an organizational level. Bias can manifest itself in many ways, and it’s up to all of us to act, regardless of industry or sector.

While each of these 10 actions represents work prioritized by BCBS Companies, we encourage other organizations and leaders to identify how the actions could be applied to their work.

A Renewed Call to Action

We alone cannot measurably impact the health inequities women of color face today. And if the pandemic has taught us anything, it’s that we cannot solve system-wide problems in a vacuum—particularly when lives are at stake.

The root causes of disparities must be addressed systemically and across a woman’s life span—not just while she is pregnant. We’re calling upon leaders in the public and private sectors to adopt these 10 actions, as well as advocate for mothers across the country through policy and partnerships:

  • Congress should pass the Congressional Black Maternal Health Caucus' Momnibus package which takes steps to improve health outcomes for pregnant women and mothers of color, their babies and their families.
  • States should adopt the American Rescue Plan Act provision—giving the option to extend Medicaid coverage from 60 days to a full year postpartum—which can positively impact the 43% of all births in the United States covered through Medicaid.
  • Health care professionals and providers should partner with organizations that provide implicit bias and cultural humility training, similar to the efforts underway with BCBS companies and the March of Dimes.

It is with both gravity and optimism that we invite policymakers, insurers, employers, hospital groups, and private practices to work toward a better more equitable system of health for all mothers.

Kim A. Keck is President and CEO of the Blue Cross Blue Shield Association, a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.


Blue Cross Blue Shield Association is a 2022 Aspen Ideas: Health underwriter. The views and opinions of the author are their own and do not necessarily reflect those of the Aspen Institute.  

Thank you for signing up!

Please provide a valid email address.

Please provide a valid email address.
aerial 2019 campus
Sign up to receive the latest news from Aspen Ideas.