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Session Details

The IHI Virtual Expedition: Triple Aim Approaches to Maternal and Infant Health will introduce the Institute for Healthcare Improvement's (IHI’s) population approach to improving maternal and infant health and care, share innovations and provide action-orientated advice for improving care delivery and health upstream for mothers and babies. 

Medicaid finances nearly half of all births in the US each year. Among that population is a high prevalence of poor birth outcomes. The rate of preterm birth a major cause of excess neonatal mortality and morbidity, high costs, and family disruption — is 25 percent higher in the Medicaid population than in the commercially insured population. 

Amid changes in access, payment, and delivery models, many states, communities, and organizations are developing strategies to improve care and reduce costs for Medicaid populations. However, no state or region has developed a comprehensive approach to improving health and care for pregnant women. Given the large proportion of Medicaid costs related to perinatal care and the substantial potential to reduce disparities, a focused effort on prevention in this population represents a significant opportunity for improvements in outcomes, costs, and social cohesion. 

Based on the research completed to date, this Expedition offers insights and practical methods on how a community can improve health and health outcomes for women, reduce rates of preterm birth, and decrease per capita costs of care. This approach includes four key interventions that have been successful in reducing preterm birth and disparities in birth outcomes: 
  1. Integrating substance use treatment with perinatal care 
  2. The maternity medical home model 
  3. Improving pregnancy intention and increasing access to effective contraception 
  4. Peer support models, including group prenatal care


IHI expert faculty working in the field of improving maternal and infant health and care will share innovative models and approaches to improving the upstream care of mothers to address outcomes for women and babies. At the end of the Expedition each participant will be able to: 
  • Explain the population approach to improving maternal and infant health and care 
  • Develop evidence-based strategies for improving the care of pregnant women and babies in their own organization, health system, community or population of care 
  • Describe the benefits of innovating and improving upstream care models for pregnant women, in terms of outcomes for individuals, the population and the impact on the cost of care 
This  IHI Virtual Expedition is approved for a maximum of 5 continuing education credits  for physicians and nurses.


Session 1: Overview: Designing a Triple Aim approach to maternal health and care 
Date: March 9, 2017 
Time: 2:00 PM–3:00 PM ET 

Session 2: Nurturing trust: integrating addiction treatment and perinatal care 
Date: March 23, 2017 
Time: 2:00 PM–3:00 PM ET 

Session 3: Population health and maternity medical home models 
Date: April 6, 2017 
Time: 2:00 PM–3:00 PM ET 

Session 4: Going upstream: addressing pregnancy intention and shared decision making 
Date: April 20, 2017 
Time: 2:00 PM–3:00 PM ET   

Session 5: Achieving the Triple Aim: Clinical and Community Care across the Continuum
Date: May 4, 2017 
Time: 2:00 PM–3:00 PM ET 

Learn more about course Materials & Technology .


Kathy Duncan, IHIMarian Bihrle Johnson, MPH, is a Director and Improvement Advisor at the Institute for Healthcare Improvement (IHI). Ms. Johnson is a lead on the IHI Innovation team for which she develops content to inform IHI’s programs and to further IHI’s strategic priorities. Ms. Johnson also leads research and policy initiatives related to several IHI programs, including those aiming to improve care for Medicaid enrollees and a multi-state initiative to reduce avoidable rehospitalizations. 
Benjamin MilliganLucy Pickard, MBBS BSc MPH MRCPCH, is a London pediatric fellow at St. Mary’s Hospital. Lucy is in training in pediatrics and neonatology in London, with parallel research interests in childhood tuberculosis and the factors influencing the presentation of feverish children to the emergency department. Lucy gained a MPH from Harvard School of Public Health, concentrating in Maternal and Child Health. She researched the outcomes of teen pregnancy at the Martha Eliot Health Center and worked as a Teaching Fellow in Sociology. She is a graduate of Imperial College, having intercalated a BSc in cardiovascular sciences, during which she researched the prevalence of hypertension among HIV-positive patients in North West London.

Kathy Duncan, IHIDaisy Goodman, CNM, DNP, MPH, is a certified nurse-midwife and researcher at Dartmouth-Hitchcock Medical Center and the Geisel School of Medicine, and a member of the treatment team at the Dartmouth-Hitchcock Perinatal Addiction Treatment Program. She divides her time between clinical practice, research, and program development to improve care for pregnant and postpartum women with substance use disorders. Her research focuses on the intersection of trauma history and drug addiction during pregnancy and on opportunities for patient engagement and co-production of care within this context.  

Benjamin MilliganKate Berrien, RN, BSN, MS, has directed Community Care of North Carolina’s Pregnancy Medical Home (PMH) program, a statewide quality improvement and population management model aimed at improving birth outcomes in the Medicaid population, since its launch in 2011. She is responsible for the guiding the program’s clinical quality improvement initiatives and oversees performance measurement and state- and practice-level analytics. 

Benjamin MilliganHelen Bellanca, MD, MPH, Associate Medical Director of Health Share of Oregon, is on the faculty of Oregon Health and Science University. A family physician, she has expertise in reproductive health, healthy weight management in primary care, and health care reform and health policy. Dr. Bellanca is the co-founder of the One Key Question initiative. Her current work centers around behavioral health integration in maternity care, including an initiative to screen all women for behavioral health and social complexity using a comprehensive screening tool called the Family Well-Being Assessment. She also leads Project Nurture, which is a clinical model of integrated maternity care and substance use treatment.