Medicaid prenatal care: a comparison of use and outcomes in fee-for-service and managed care
| Autor: | Frederick A. Connell, James Krieger, J P LoGerfo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1992 |
| Předmět: |
Gerontology
medicine.medical_specialty Cost Control Birth weight Prenatal care Birth certificate Health Services Accessibility Pregnancy medicine Birth Weight Humans Fee-for-service health care economics and organizations Retrospective Studies business.industry Medicaid Managed Care Programs Public Health Environmental and Occupational Health Health services research Pregnancy Outcome Retrospective cohort study Prenatal Care United States Fees Medical Family medicine Birth Certificates Managed care Female Health Services Research business Research Article |
| Popis: | 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, providing financial access and modifying the system of care for this population did not result in parity with the general population. |
| Databáze: | OpenAIRE |
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