Texas Medicaid Payment Reform: Fewer Early Elective Deliveries And Increased Gestational Age And Birthweight
| Autor: | Heather M. Dahlen, Angela R. Fertig, Bryan E. Dowd, William J. Riley, J. Mac McCullough |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty media_common.quotation_subject Gestational Age 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Labor Induced health care economics and organizations Full Term media_common 030219 obstetrics & reproductive medicine Obstetrics business.industry Cesarean Section Medicaid Health Policy Infant Newborn Pregnancy Outcome Gestational age Payment medicine.disease Texas United States Premature birth Elective Surgical Procedures Gestation Premature Birth Female Health Expenditures Elective Surgical Procedure business |
| Zdroj: | Health affairs (Project Hope). 36(3) |
| ISSN: | 1544-5208 |
| Popis: | Infants born at full term have better health outcomes. However, one in ten babies in the United States are born via a medically unnecessary early elective delivery: induction of labor, a cesarean section, or both before thirty-nine weeks gestation. In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states. We found that early elective delivery rates fell by as much as 14 percent in Texas after this payment policy change, which led to gains of almost five days in gestational age and six ounces in birthweight among births affected by the policy. The impact on early elective delivery was larger in magnitude for minority patients. Other states may look to this Medicaid payment reform as a model for reducing early elective deliveries and disparities in infant health. |
| Databáze: | OpenAIRE |
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