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Request for Information (RFI) on Severe Maternal Morbidity (SMM)

Feb 6, 2024

The Agency for Healthcare Research and Quality (AHRQ) has released a Request for Information (RFI) on Severe Maternal Morbidity (SMM). AHRQ is seeking public input on the usability, feasibility, and likely uptake of an SMM measure, produced through the Quality Indicators program using administrative data, with the intent of promoting maternal health service improvements at an area level ( e.g., county, state). AHRQ invites stakeholders representing consumers, state/regional/local health departments, accountable care organizations, community health centers, birthing centers, providers/health systems, critical access/rural hospitals, professional associations, payers, rural and community health groups, community health workers, doulas, maternal health advocacy groups, researchers, and other members of the public to comment.

Specific questions of interest include, but are not limited to:

  1. If you are currently measuring severe maternal morbidity in your organization, what measure(s) are you or your organization using? How do you use these measures? What data sources are you using? Please specify organization type in your answer.
  2. If you or your organization are not currently measuring severe maternal morbidity, what quantitative data would you need to make maternal health service improvements? Please specify organization type in your answer.
  3. At what level—state, county, or some other level—would information be most helpful for improving maternal health services? In what ways?
  4. The measure currently used by AHRQ for severe maternal morbidity uses 21 indicators identified with ICD–10CM10CM/PCS codes in administrative data. Considering these indicators:
    1. What codes might be missing? Are there changes you would you recommend?
    2. In what ways would the changes that you propose make a severe maternal morbidity measure more useful to your organization?
    3. Would a measure with the refinements you propose be useful for surveillance? Population health management? Clinical quality improvement? Program evaluation? Research? Public reporting or accountability programs? In what ways?
  5. What other measures of maternal health and/or morbidity would your organization find useful/effective for improving maternal health services, including any potential measures for use in either the prenatal or postpartum time periods?

AHRQ is interested in all of the questions listed above, but respondents are welcome to address as many or as few as they choose and to address additional areas of interest not listed. It is helpful to identify the question to which a particular answer corresponds. The comment period closes on March 4th and comments should be sent to

Source: Agency for Healthcare Research and Quality, Health Resources & Services Administration's Maternal & Child Health Bureau