Feb 10

NACPM Steps Up to Advocacy for Quality Improvement

national association of certified professional midwives
NACPM Steps Up to Advocacy for Quality Improvement
February 10, 2014
Autumn Vergo
Autumn Vergo,
New NQF Rep
In This Issue:
Letter From Executive Director
Autumn Vergo, New NACPM Rep to NFQ
Mandatory Reporting on Perinatal Core Measures
Improve Medicaid Coverage
Quality Rating System
Quality Improvement Skills Training
Join or Renew NACPM Membership

Quick Links: 




Coalition for Quality Maternity Care


Quality Rating System


Institute for Healthcare Improvement 



Letter From Executive Director


NACPM is actively collaborating with other maternity care professionals and stakeholders to influence critical national policy. Together we are working to improve the quality of maternity care services for all women, bringing the valuable skills and perspectives of CPMs to a number of national policy tables.


Please read below for news of NACPM’s recent opportunities, as a founding member of the Coalition for Quality Maternity Care, to influence Federal agencies on behalf of better care and more consumer choice for childbearing women. See how your professional organization is stepping up to quality improvement in maternity care through our long-standing membership in the National Quality Forum (NQF), and read about our new representative to the NQF, Autumn Vergo, CPM.


Autumn will be traveling to Washington, D.C. this week on behalf of NACPM to participate in the NQF’s 2014 Annual Conference, “Making Sense of Quality Data for Patients, Providers, and Payers.” Watch for a report of the conference and its relevance to CPMs and the mission of NACPM on her return.


And be sure to check out the opportunity for building your quality improvement skills!




Mary Lawlor, Executive Director 

National Association of Certified Professional Midwives

NACPM Appoints New Representative to the NQF

NACPM is pleased to announce that Autumn Vergo, CPM from New Hampshire and NACPM board member, has accepted the appointment as NACPM’s representative to the National Quality Forum.

Autumn Vergo
Autumn Vergo

Autumn’s interest in quality improvement developed over several years’ service as a member of northern New England’s regional, multi-hospital quality improvement network. She has worked alongside pediatricians, obstetrician/gynecologists, midwives and nurses on several projects intended to improve communication between hospital-based providers and community midwives, and serves as a case reviewer on her region’s Confidential Review and Improvement Board. Her cross-training as both a Certified Professional Midwife and a Registered Nurse help her to bridge the gap between care models and effectively represent the midwifery community on issues of best practice, safety, and quality improvement. 


is a non-profit organization that promotes quality and change in the health care system through development and implementation of a national strategy for health care quality measurement and reporting. NQF membership includes a wide variety of healthcare stakeholders, including consumer organizations, public and private purchasers, physicians, nurses, hospitals, accrediting and certifying bodies, supporting industries, and healthcare research and quality improvement organizations – and midwives: NACPM has been a member of NQF since 2008, reflecting NACPM’s commitment to improving the quality of care for all women.  


Autumn will represent NACPM at NQF’s 2014 Annual Conference, “Making Sense of Quality Data for Patients, Providers, and Payers” in Washington, D.C. this month. The NQF annual conference brings together more than 400 healthcare professionals, quality experts, and member organization executives and staff from across the United States, all of whom are dedicated to driving quality improvement within our healthcare system.

A Victory for Women and Families: Reporting on Perinatal Core Measures Becomes Mandatory


Beginning this month, mothers and families will be able to see and compare how hospitals care for women and their infants, including their primary cesarean section, elective delivery and breastfeeding rates.


The Joint Commission, a nonprofit organization that accredits more than 20,000 health care organizations and programs in the U.S., has decided to require mandatory reporting for hospitals with more than 1100 births a year, on 5 of the 17 childbirth-related performance measures developed by the National Quality Forum. In 2013, this reporting was voluntary, with only 160 of the nation’s thousands of hospitals participating. Now with the new mandatory reporting requirement for accredited hospitals, consumers will have access to important information from hospitals around the country at www.qualitycheck.org and be able to make better informed decisions about choosing care providers.


“With more than four million births in the United States each year, perinatal measures are needed to ensure the health and well-being of new mothers and newborns,” said Janet Corrigan, PhD, MBA, president and CEO of NQF in announcing its endorsement in 2012. “This set of measures will help promote the type of high-quality care these populations deserve.”


As a member of NQF, NACPM provided comments to the organization during the development of perinatal quality measures that were approved for endorsement in April 2012. These measures address a wide range of care concerns, including childbirth, pregnancy and post-partum care, and newborn care.


It is anticipated that mandatory reporting will eventually lead to lower cesarean sections, fewer elective deliveries, higher breastfeeding rates and other care improvements for mothers and infants.

NACPM Joins National Conversation to Improve Medicaid Coverage for Pregnant Women and Children

midwife hands for ictc article

NACPM is a founding member organization of the Coalition for Quality Maternal Care (CQMC), a partnership of national professional, consumer, and human rights organizations that have come together to champion the urgent need for national strategies to ensure access to affordable, high quality maternity care for all women and infants.


On January 6, NACPM signed a letter sent by the ACNM on behalf of CQMC members to the Medicaid and CHIP Payment and Access Commission (MACPAC) providing specific recommendations regarding issues related to maternity care. MACPAC is a non-partisan, federal agency charged with providing policy and data analysis to the Congress on Medicaid and CHIP, and for making recommendations to the Congress and the Secretary of the U.S. Department of Health and Human Services, and the states on a wide range of issues affecting those programs.  The goal of the CQMC was to foster continued focus on maternity care by MACPAC as much of its previous work has centered on other aspects of coverage under Medicaid.


MACPAC responded to the CQMC letter, indicating that the recommendations had been circulated to commissioners and appropriate staff.  The Commission has included a chapter providing general information on Medicaid’s maternity care in one of its previous reports and plans to include recommendations regarding maternity care in a forthcoming report, focused on the complexities around Medicaid coverage for pregnant women.

New This Year:
Quality Rating System
to Inform Pregnant Women


The Centers for Medicare and Medicaid Services (CMS) is implementing a requirement of the Affordable Care Act to develop a Quality Rating System (QRS) to assist consumers as they make decisions regarding their health plans. As part of this process, CMS is soliciting comments on a list of proposed quality measures that Qualified Health Plan issuers would be required to collect and report on.


NACPM has joined the CQMC in a submitting a letter expressing appreciation to CMS for identifying maternity care as an area which merits distinct measurement. To date, CMS has proposed including only one measure, out of a total of 42, that rates two factors related to maternity care. Given the place of maternity care within the health system in terms of both number of procedures and cost, CQMC believes that two measures are insufficient, stating, “We believe that this group of women and their partners will be very interested in information regarding the quality of maternity care provided through the plans available to them.”


The coalition recommends three priority measures (exclusive breastfeeding; cesarean section rate for low-risk women; timeliness of prenatal & postnatal care) and four additional measures for consideration in the development of the Quality Rating System.


In addition the coalition recommends to CMS, “because women may choose to obtain care from a variety of provider types (e.g., OB/GYNs, Family Practice physicians, Certified Nurse Midwives/Certified Midwives, Certified Professional Midwives), and in different settings (e.g., hospitals, birth centers and residences) it would be helpful if…plans report this data broken down by provider type and place of service. Consumers would thus have access to more specific and useful information to guide them in their enrollment choices.

Join Virtual Community

for Quality Improvement Skills


NACPM has recently learned that Diana Jolles, CNM, MS, the ACNM Quality Section Chair has a plan to deliver quality improvement skills to the midwife community in the United States through the Institute for Healthcare Improvement.

Jolles, a professor at Frontier Nursing University in Kentucky, is creating a virtual community for students, faculty, and practicing midwives. All midwives, Jolles says, are welcome to join the group, which will learn from the IHI Open School courses throughout 2014.

Jolles sees big challenges – and big opportunities – in the field of quality and safety in the midwife community. This virtual community will include monthly webinars to complement learning from the Open School courses. The first webinar “Increasing Midwifery-led Quality Improvement Capability” has already taken place. Webinars still to be offered include:

  • “Quality Improvement and Perinatal Safety,” on February 6

  • “Midwifery Leadership and Quality Improvement,” on March 6

  • “Person- and Family-Centered Care Midwifery-led Quality Improvement Programs,” on April 7

Email Diana to learn more about the midwife community she is launching.

Please join NACPM in our ongoing work to advocate for quality improvements in national maternity care.


Join or renew your membership, if you haven’t already; invite others to join; and like us on Facebook today to help spread the word.



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Mary Lawlor, Executive Director


Ellie Daniels, President