Report

Opportunities to Increase Participation in Michigan's Maternal Infant Health Program

October 2020
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Robin Tepper Jacob, Megan Foster Friedman

Home visiting is an evidence-based strategy to promote the health and well-being of pregnant people, new parents, and babies. The Maternal Infant Health Program (MIHP) is Michigan’s largest evidence-based statewide home visiting program for Medicaid-eligible pregnant individuals and infants under one year old. Home visitors typically begin working with beneficiaries during their pregnancy and then continue to provide home visiting services through pregnancy, the postpartum period, and up to the infant’s first birthday.

Quasi-experimental studies have found that individuals who enroll in MIHP before their third trimester and receive at least three home visits (i.e., “full” participation) have a 23% lower risk of low birth weight and a 26% lower risk of preterm birth, the primary drivers of infant mortality.5 Yet MIHP enrolls less than 30% of all Medicaid-eligible pregnant people in the state. Increasing participation in the program could potentially help improve maternal and infant health for more Michiganders.

a young couple having a play time with their toddler daughter on carpet

Key findings

  1. Michigan’s Maternal Infant Health Program (MIHP) currently enrolls less than 30% of all eligible individuals across the state. Among MIHP enrollees, only about 60% participate “fully,” meaning they enrolled prenatally and received at least three home visits.
  2. Increasing MIHP’s take-up and retention can help more parents access vital prenatal and post-partum support.
  3. Lack of awareness is a major barrier to MIHP enrollment. Various systems-level activities to promote awareness of home visiting could help ensure eligible beneficiaries know these services are available to them.
  4. Many MIHP participants cited scheduling conflicts as a reason for ending MIHP early. Others said they did not sign up for MIHP because they did not want someone coming into their home. Incorporating additional flexibility into MIHP’s model of service delivery – for example, by expanding the use of virtual visits, offering more flexible visiting hours, and encouraging home visitors to meet with individuals in locations outside of the home – may help overcome these barriers to enrollment and participation.