The impact of the Medicaid high-risk ob care management program in New York State
| Autor: | Lindsay Cogan, Young Park, Stephen Weinberg |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
media_common.quotation_subject Pregnancy High-Risk Child Health Services New York Probit Prenatal and Perinatal Care Management and Payment 03 medical and health sciences 0302 clinical medicine Pregnancy Medicine Humans Maternal Health Services 030212 general & internal medicine media_common Retrospective Studies Selection bias Medicaid managed care business.industry Medicaid 030503 health policy & services Health Policy Infant Newborn Gestational age Retrospective cohort study Percentage point Prenatal Care United States Female Heckman correction 0305 other medical science business Demography |
| Zdroj: | Health Serv Res |
| ISSN: | 1475-6773 |
| Popis: | OBJECTIVES: To examine the effect of high‐risk obstetrics (HROB) care management on infant health and Medicaid expenditures. DATA SOURCES/STUDY SETTING: Medicaid administrative data and vital statistics from 2011 to 2013. In New York State, all Medicaid managed care plans provide HROB care management to their members. STUDY DESIGN: We conducted a retrospective cohort study with a nonequivalent control group. Selection bias was addressed by using probit and OLS models with the Heckman correction and inverse probability weight with regression adjustment. PRINCIPAL FINDINGS: While program enrollment was associated with poor infant health outcomes (low birthweight, very low birthweight, preterm delivery, and gestational age), correcting for sample selection substantially improved most of these outcomes. All infant health outcomes significantly improved as the number of weeks in the program increased. We found that a 1‐week increase in program duration is associated with a 0.01 percentage point decrease in low birthweight and a 0.03 percentage point decrease in very low birthweight. Further, a 1‐week increase in program duration decreases the probability of preterm delivery by 0.01 percentage points and increases gestational age by 0.14 days. Medicaid expenditures for maternity care and newborn delivery were not significantly or materially affected by program enrollment or program duration. CONCLUSIONS: High‐risk obstetrics care management appears to successfully identify individuals with high‐risk pregnancies and improve health without substantially increasing medical expenses. |
| Databáze: | OpenAIRE |
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