How Our Program Works
We bridge the gap between having Medicaid coverage and actually receiving timely, effective postpartum mental health care. Our approach is built on three integrated pillars:
Structured Program Delivery
We proactively reach postpartum members through HIPAA-compliant phone and video calls, in their preferred language, with trained outreach specialists who understand cultural and logistical barriers.
Validated Screening & Risk Identification
Using the Edinburgh Postnatal Depression Scale (EPDS), we detect depression symptoms early, identify high-risk cases, and ensure no mother falls through the cracks.
From scheduling appointments to arranging transportation, we guide mothers through every step, removing barriers that prevent care and following up until they’re connected to the right support.
Comprehensive Care Coordination
Our Step‑by‑Step Process: From Outreach to Outcomes
2: Proactive, Multilingual Outreach
Phone, text, and video outreach in the member’s preferred language—multiple touch attempts at best‑time windows to maximize reach and trust.
3: Validated EPDS Screening
Administer the Edinburgh Postnatal Depression Scale; document scores and risk level in real time.
1: Identify Eligible Members
Secure data exchange with the plan to flag postpartum members (within 12 months of delivery). HIPAA-compliant intake; align on consent and reporting.
5: Ongoing Care Navigation
Follow‑ups, reminders, and check‑ins to drive adherence; coordinate with plan case managers and escalate when appointments are missed.
6: Outcomes & Reporting
Weekly engagement/screening dashboards and quarterly outcomes tied to Core Set/HEDIS. Close gaps, demonstrate ROI, and feed data back into plan workflows—no new tech burden for your teams.
4: Warm Referral & Scheduling
High‑risk (e.g., EPDS ≥10) members are immediately connected to in‑network behavioral health/OB providers. We handle scheduling and remove barriers (transportation, childcare, language).
Outcomes and Value to Health Plans
Our approach delivers measurable impact for health plans and the mothers they serve, reaching over 85% of postpartum members, referring 100% of high EPDS scores, and achieving 90%+ adherence. With the potential to cut maternal health costs by 10–20%, our model saves an estimated $1.86M for every 1,000 postpartum outreach contacts, while improving lives and outcomes at scale.
Why Partner With PQS
30+ Years Expertise
Proven Medicaid Results
Policy-Aligned Solutions
Decades of operational and clinical leadership in maternal and behavioral health, delivering programs that work in the real world.
Successful track record improving access, equity, and quality for Medicaid behavioral health initiatives with measurable outcomes.
Fully aligned with Medicaid Core Set and equity mandates, helping health plans meet requirements while improving member health.
Let’s Improve Maternal Mental Health Outcomes Together
Every mother deserves timely, effective mental health care. Partner with Prime Quality Solutions to close postpartum care gaps and improve outcomes. Fill out the form below to book your call today.
