Call for Collective Transparency
Collective Transparency in Medicaid-Funded Doula Services
Collective transparency is a shared, public commitment: managed care organizations (MCOs), government agencies, and community-based organizations pledge to be openly accountable to low‑income birthing people—especially around the laws, funding, policies, and timelines shaping doulas’ services.
Key Elements of Collective Transparency
Full Disclosure of Program Structure
Clearly communicate program duration, eligibility periods, and any anticipated policy or funding changes.Transparency Around Funding & Policy Shifts
If funding is reduced or restricted, stakeholders should report it and explain the impact on benefit levels and provider compensation.Provider Guidance & Support
Offer practical assistance and clear instructions for doulas enrolling as Medicaid providers—instead of shifting enrollment burdens onto providers without support.Client-Centered Accountability
Ensure transparent communication extends directly to doulas and clients so they fully understand the context behind service offerings and limitations.
Why It Matters
1. Builds Trust & Empowers Decision-Making
When doulas and clients understand how long programs operate, how they are funded, and what enrollment entails, trust grows—and everyone is better able to make informed choices.
2. Supports Equitable Access
Lack of awareness of funding limits or program reductions can undermine equity efforts. Transparent communication ensures doulas serve communities meaningfully.
3. Strengthens Provider Sustainability
Community-based doulas often face administrative burdens and low pay. Without transparent systems of support and payment, these providers struggle to maintain sustainable practices.
Context & Broader Significance
Doula services are increasingly covered by Medicaid across states, with evidence showing positive outcomes such as reduced cesarean rates, shorter labor, and cost savings for insurers. Countries that reimburse doulas often see improved maternal and infant health outcomes.
However, many doulas report challenges enrolling in Medicaid systems—gaps in guidance, uncertain credentialing, and uneven reimbursement rates.
Programs are evolving: several states now provide doula reimbursement in Medicaid, and Medicaid expansion continues. Collective transparency is crucial to ensuring these policies work effectively for providers and clients alike.
A Call to Action
To implement collective transparency effectively, stakeholders should:
Engage providers in policy design to ensure enrollment and reimbursement systems reflect real-world doula experiences.
Communicate clearly and directly with both clients and doulas about program timelines, eligibility, and funding shifts.
Monitor and adapt reimbursement models to provide fair, sustainable compensation—helping rehabilitate the growing value doulas bring into Medicaid‐funded care.
In Summary
Collective transparency is more than policy jargon—it’s a core accountability practice. When payers, agencies, and community organizations commit to openness, doula services become more accessible, sustainable, and trusted—especially for low‐income families. This approach advances health equity, provider resilience, and informed, empowered birth experiences.
