Virginia pilot would give pregnant Medicaid members remote health monitoring

The Department of Medical Assistance Services would run a remote monitoring pilot for pregnancy-related high blood pressure and diabetes. The pilot would serve up to 500 pregnant medical assistance members enrolled in a participating managed care organization, in localities selected by the Department. The Department would select one or more managed care organizations and one technology vendor to run the program. The Department would pay participating plans no more than $500,000 to cover vendor and program costs. The pilot is described for fiscal years 2027 and 2028. It would have to begin within 180 days after the participating plan and technology vendor sign their contract.

The technology vendor would provide monitoring devices and clinical support during pregnancy and for up to three months after birth. The devices and clinical team would serve eligible pilot participants. The care team would include licensed nurses, dietitians, and certified diabetes care and education specialists. Devices would collect and securely send health data for a provider to review, and must be authorized by the U.S. Food and Drug Administration. A clinical care team would review readings, provide coaching, and coordinate with the participant's provider. When readings and symptoms call for immediate attention under clinical guidelines, the team would use an agreed process to involve the provider. Monitoring would be available during pregnancy and for up to three months postpartum.

The Department would evaluate the pilot and report its findings and recommendations to state leaders. The report would go to the Governor and the listed chairs of Senate and House committees on finance and appropriations, education and health, and health and human services. The evaluation would use participants' claims, vital statistics, and electronic health record data to assess maternal, fetal, and newborn health outcomes and whether the pilot improves outcomes while reducing Medicaid costs. The report would be due no later than 18 months after the first participant enrolls.