Medicaid is a principal payer for maternity services in many states across the country. This study examines the importance of Medicaid as a payer for maternity care through a comparative analysis of the Medicaid policies and birth outcomes of four states: Georgia, Illinois, New York and Pennsylvania. Mixed methods were used to examine and compare policy and outcome variables in each state. Study results demonstrate that low-income women are not receiving proper preconception and interconception care. Preconception and interconception care are particularly important, as the majority of Medicaid pregnancies in the states studied were unintended. Additionally, between 21% and 33% of women received late or no prenatal care. The policy data collected found that many of the Medicaid policies across the states are the similar, but utilization of services, such as prenatal care, is not the same. This study also found that there is a significant lack of data, especially quality outcomes data. Outcomes data was not collected by the Centers for Medicare and Medicaid Services, nor was it uniformly collected across the states. Only two out of the four states actually tracked birth outcomes in the Medicaid population. Outcomes data needs to be collected for the Medicaid population to ensure that the policies are having a positive impact on women. This study recommends that states be required to submit reports on Medicaid policies and birth outcomes and that these reports be shared with all states. The rates of preconception and interconception care and other outcome measures should also be studied after the implementation of the Affordable Care Act to see if low-income women experience improvements in care.
Presentation: 19 minutes
Spanier, Alison, "A Comparative Policy Analysis: Medicaid as a Payer for Maternity Care Services" (2014). Master of Public Health Capstone Presentations. Presentation 117.