Oregon data

From Jan. 1, 2016 to Dec. 25, 2020, the Oregon Health Authority (OHA) and coordinated care organizations (CCOs) have paid doulas less than $37,000 for supporting Medicaid clients through prenatal and postpartum visits and approximately 204 births. Roughly 19,000 people a year give birth while enrolled in Oregon Health Plan, the state’s Medicaid program.

Quick points based on OHA data from Jan. 1, 2016 to Dec. 25, 2020^*:

Delivery method among doula-supported Medicaid births

• Out of 227 claims, 204 were connected to labor support, and 23 claims were solely for maternity support visits.
• About 89 percent of doula-supported births were vaginal deliveries, including vaginal births after a Cesarean section (VBAC).
• Approximately 11 percent of doula-supported births were Cesarean sections.

Prenatal and postpartum support

• More than 85 percent of clients received doula support throughout labor and four times during the prenatal and postpartum periods.

People who received doula support

• They were mostly between the ages of 20 and 39.
• A vast majority lived in Washington County. Other counties where people received doula support included: Benton, Clackamas, Clatsop, Crook, Jackson, Josephine, Lane, Lincoln, Linn, Marion, Multnomah and Polk counties.
• English (52 percent) and Spanish (45 percent) were the most common household languages spoken.
• The OHA does not report clients’ race/ethnicity at this time.

Cost

• Out of 227 claims, CCOs paid for 36 percent. The total cost to CCOs was $23,968.
• The remaining 64 percent of claims were paid through fee-for-service (FFS). The total cost was $12,475. If a Medicaid client is not enrolled with a CCO, they have an OHP “open card.”

^*Doula services were added as a covered service on the Oregon Health Plan in 2014. However identification of a doula as the performing provider is not available in claims until 2016. For consistency, the OHA only reported claims since 2016. For much of 2020, doulas were excluded from Oregon hospitals due to COVID-19 restrictions.

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