Review of VHA Maternity Care Coordination and Women Veterans’ Experience

The VA Office of Inspector General (OIG) conducted a national review of VHA’s coordination of maternity care, which is largely delivered through community providers. VHA’s maternity care coordination program helps pregnant veterans navigate both VHA services and community care during the pregnancy and for one year following delivery.

The OIG found that VHA providers largely complied with requirements to refer patients to prenatal care as early as possible, and 77 percent of patients attended their first community prenatal appointment in the first trimester. Most pregnant patients had all required contact attempts documented by a maternity care coordinator during pregnancy. However, only half had all required postpartum contact attempts documented in the EHR during the year after delivery, and required postpartum screenings for depression, relationship health and safety, housing and food security, and alcohol use were not consistently offered. These findings show facilities are not yet in compliance with postpartum care coordination requirements.

Approximately one in three patients saw their VHA primary care provider within three months of delivery, indicating opportunities to improve timely transition back to primary care.

Nearly all women veterans who responded to an OIG survey sent during the review reported having contact with a maternity care coordinator and were largely satisfied with the support received. However, billing concerns were frequently reported, aligning with the OIG’s finding that one in four records reviewed contained documentation of billing issues, underscoring the need for streamlined administrative processes to resolve billing issues for community maternity care.

The OIG made four recommendations to the Under Secretary for Health focused on improving compliance with postpartum care contacts and screenings, evaluating community care billing processes, and ensuring timely scheduling of postpartum primary care appointments. 

The Under Secretary for Health concurred with two recommendations, concurred in principle with two recommendations, and provided acceptable action plans.