Abstract
Objective
To compare patterns of routine postpartum health care utilization for women in Wisconsin with continuous Medicaid eligibility versus pregnancy-only Medicaid
Methods
This analysis used Medicaid records and linked infant birth certificates for Medicaid paid births in Wisconsin during 2011–2015 (n = 105,718). We determined if women had continuous or pregnancy-only eligibility from the Medicaid eligibility file. We used a standard list of billing codes to identify if women received routine postpartum care. We examined maternal characteristics and receipt of postpartum care overall and by Medicaid eligibility category. Finally, we used a binomial model to calculate the relationship between Medicaid eligibility category and receipt of postpartum care, adjusted for maternal characteristics.
Results
Women with continuous Medicaid had profiles more consistent with low postpartum visit attendance rates (e.g., younger, more likely to use tobacco) than women with pregnancy-only Medicaid. However, after adjusting for maternal characteristics, women with continuous Medicaid eligibility had a postpartum visit rate that was 6 percentage points higher than the rate for women with pregnancy-only Medicaid (RD: 6.27, 95% CI 5.72, 6.82).
Conclusions for Practice
Women with pregnancy-only Medicaid were less likely to have received routine postpartum care than women with continuous Medicaid. Medicaid coverage beyond the current guaranteed 60 days postpartum could help provide more women access to postpartum care.
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Acknowledgements
The authors thank the Wisconsin Department of Health Services for sharing the data used in this analysis.
Funding
Carla DeSisto was supported by the University Fellowship from the Graduate College at the University of Illinois at Chicago, as well as the Hamilton Research Scholarship, the Dr. Sharon L. Telleen Maternal and Child Health Award, and the Maternal and Child Health Epidemiology Doctoral Training Program from University of Illinois at Chicago School of Public Health.
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DeSisto, C.L., Rohan, A., Handler, A. et al. The Effect of Continuous Versus Pregnancy-Only Medicaid Eligibility on Routine Postpartum Care in Wisconsin, 2011–2015. Matern Child Health J 24, 1138–1150 (2020). https://doi.org/10.1007/s10995-020-02924-4
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DOI: https://doi.org/10.1007/s10995-020-02924-4