Medicaid Prenatal Care: A Comparison of Use and Outcomes in Fee-For-Service and Managed Care.

PRENATAL care; MEDICAID; HEALTH insurance; MEDICAL care costs; MANAGED care programs; PUBLIC health; HEALTH planning

Background. To control rising costs, state Medicaid agencies are enrolling recipients in managed care health plans (MCPs). We performed this study to assess this policy's impact on accessibility and outcomes of Medicaid-funded prenatal care. Methods. We performed a retrospective, controlled study with three cohorts: a study group of 1106 Medicaid recipients enrolled in three MCPs, a matched comparison group of 4830 recipients receiving care in the fee-for-service (FFS) system, and a second matched comparison group of 4434 non-Medicaid enrollees of the same MCPs. Data on prenatal care use and birth outcomes were obtained through linkage of claims and discharge files with birth certificate files. Results. Medicaid recipients enrolled in MCPs used prenatal care similarly to those in the FFS system and showed equal or modestly improved birth-weight distributions. However, Medicaid MCP enrollees showed poorer use of prenatal care and birth outcomes compared with non-Medicaid enrollees of the same plans. Conclusions. Enrollment in MCPs has a neutral or small beneficial effect on the prenatal care received by the Medicaid population. However, proving financial access and modifying the system of care for this population did not result in parity with the general population. [ABSTRACT FROM AUTHOR]

Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)