Maternal health has received increased attention in federal and state Medicaid reform efforts in recent years, particularly in states with elevated mortality and disparity metrics.[1] As Medicaid agencies and managed care organizations consider alternative ways of structuring prenatal care, some providers are expanding services beyond traditional clinic settings.
Nest Health recently launched Nest Origin, an in-home prenatal and midwifery program serving Medicaid beneficiaries in Louisiana. The initiative represents a significant expansion into prenatal care, focusing on the stage of pregnancy where early and consistent engagement can influence maternal and infant outcomes.
Founded in 2022, Nest Health delivers primary care through home visits and virtual services, primarily to Medicaid populations. Its model integrates medical care, behavioral health, and social supports within a coordinated framework. By entering the prenatal phase, Nest is seeking to address gaps in access and continuity before delivery occurs.
Nest Origin provides prenatal visits, screenings, and fetal monitoring through certified nurse midwives via in-home and telehealth encounters. Labor and delivery remain hospital-based, with coordination between community providers and obstetric teams. The program also emphasizes continuity into the postpartum period.
Louisiana continues to report among the higher maternal mortality rates nationally, with disparities affecting low-income populations and communities of color.[2] Structural barriers such as transportation limitations, childcare responsibilities, and fragmented care often disrupt consistent prenatal engagement. A home-based model attempts to address those barriers by bringing care directly to patients rather than relying solely on office-based visits.
The program’s rollout will be evaluated in collaboration with academic researchers. As Medicaid agencies continue to prioritize maternal health outcomes, home-centered prenatal models may become a more prominent component of state innovation strategies. Whether such approaches scale will depend on measurable improvements in clinical outcomes, utilization patterns, and overall cost performance.
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[1] https://www.cms.gov/priorities/innovation/innovation-models/tmah