Summary: Black maternal health disparities remain one of the nation’s most pressing healthcare challenges, requiring innovative, community-focused solutions. Explore how Federally Qualified Health Center (FQHC) Look-Alike models can expand access to comprehensive maternal healthcare, improve outcomes for underserved populations, and help healthcare organizations address persistent inequities through strategic partnerships and sustainable care delivery.

Despite spending more on healthcare than any other developed nation, the U.S. continues to face a maternal health crisis. According to the Centers for Disease Control and Prevention (CDC), more than 85% of pregnancy-related deaths in the U.S. are considered preventable, yet maternal mortality rates remain significantly higher than peer countries.

The burden of this crisis is not experienced equally across populations. Black women in the U.S. are nearly three times more likely to die from pregnancy-related causes than white women, regardless of income or education level. As healthcare organizations evaluate long-term strategies to improve maternal health outcomes, expanding access to coordinated, community-based care has become an increasingly important focus.

Community-based healthcare models, such as Federally Qualified Health Centers (FQHCs) and Federally Qualified Health Center Look-Alikes, have emerged as scalable approaches to expanding equitable maternal healthcare access in underserved communities. These models provide comprehensive services regardless of ability to pay while leveraging enhanced reimbursement, care coordination, and community-driven support to strengthen continuity of care and reduce disparities in maternal healthcare.

What Is Driving Black Maternal Health Disparities?

The World Health Organization defines a maternal death as the death of a woman during pregnancy, childbirth, or within 42 days of the end of a pregnancy due to complications related to or aggravated by the pregnancy or its management (excluding accidental or incidental causes). Despite significant spending, the U.S. has the highest rate of pregnancy-related fatalities among developed nations, and more than 85% of those deaths are considered preventable. Significant racial disparities persist in maternal health outcomes, with Black women experiencing a maternal mortality rate of 50.3 deaths per 100,000 live births compared to 14.5 for white women, 12.4 for Hispanic women, and 10.7 for Asian women, according to the CDC.

These disparities are driven by intersecting factors, including unequal access to prenatal care, bias within healthcare settings, insurance coverage gaps, geographic barriers, and higher rates of chronic conditions such as hypertension, diabetes, and obesity. Access challenges are especially severe in “maternity care deserts,” where hospitals, birth centers, and obstetrical providers are limited or nonexistent. Today, more than 35% of U.S. counties lack adequate maternal care services and are considered maternity care deserts, affecting more than 2 million women of reproductive age. Many of these communities are also located in non-Medicaid expansion states, where women often experience coverage gaps that delay or limit access to critical prenatal care.

The impact of these disparities extends beyond maternal mortality, contributing to significantly higher infant mortality rates within Black communities and reinforcing broader inequities tied to race, geography, insurance eligibility, and social determinants of health.

How FQHCs and FQHC Look-Alikes Can Improve Maternal Healthcare Access

While the challenges are significant, community-based healthcare models such as FQHCs and FQHC Look-Alikes offer meaningful opportunities to improve maternal health outcomes by expanding access to care in underserved communities. These centers are often located in areas of high need and can become a healthcare lifeline to the community by offering services like maternal care, mental health, and family planning services regardless of ability to pay. The only distinct differences between FQHCs and FQHC Look-Alikes are the receipt of automatic malpractice coverage, stricter compliance oversight, and eligibility for Section 330 grants and capital improvement loans.

FQHCs serve more than 30 million patients annually, including underserved communities disproportionately impacted by maternal health disparities. FQHCs have demonstrated lower rates of preterm birth and low birth weight among patients receiving early and continuous prenatal care, reinforcing the importance of accessible, coordinated maternal healthcare services. In fact, improving outcomes for the marginally underserved, which includes Black and Hispanic communities, is a documented clinical area of emphasis with the federal Health Resources and Services Administration (HRSA), the executive branch overseeing FQHCs.

FQHC Look-Alikes support these efforts by allowing health systems and providers to expand care delivery in underserved communities through enhanced Medicaid and Medicare reimbursement opportunities, coordinated care services, and access to programs such as the 340B Drug Pricing Program. While FQHC Look-Alikes do not receive direct Section 330 federal grant funding, they offer many of the same operational advantages as traditional FQHCs and create opportunities to expand affordable, community-based maternal healthcare services. Community-centered interventions, including doulas, midwives, presumptive eligibility programs, and expanded postpartum Medicaid coverage can further strengthen continuity of care, improve maternal engagement, and support better long-term outcomes for mothers and infants.

Strategic Considerations for Hospitals Exploring FQHC Look-Alike Models

Addressing the Black maternal health crisis will require more than awareness alone. Expanding access to coordinated, community-based maternal healthcare services depends on collaboration between healthcare systems, policymakers, and community organizations willing to invest in sustainable care delivery models that improve outcomes in underserved communities.

KSM’s healthcare consulting team helps organizations evaluate partnership opportunities with existing FQHCs, assess the feasibility of developing FQHC or FQHC Look-Alike models, and navigate the operational, financial, and strategic considerations required to expand access and align care models with long-term population health goals.

If your organization needs help evaluating strategies to expand access to maternal healthcare services through FQHC partnerships or FQHC Look-Alike models, contact our team of healthcare consultants.

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