Primary Submission Category: Reproductive health
Maternal health outcomes among Wisconsin mothers receiving Medicaid-funded Prenatal Care Coordination Services
Authors: Madelyne Greene Kate Gillespie David Mallinson Felice Resnik Carson Borbely
Presenting Author: Madelyne Greene*
Background: Integrated models of care that offer home visiting and care coordination can support health and have the potential to reduce racial and geographic disparities. Prenatal care coordination (PNCC) is one such model. Offered as a fee-for-service Medicaid benefit, it is available in several states including Wisconsin. Some evidence suggests that PNCC may reduce preterm birth and low birth weight, but little evidence has evaluated its impact on mothers and their health outcomes.
Objectives: We aimed to describe the association of receiving PNCC services with five distinct maternal health outcomes: 1) receipt of adequate prenatal care, 2) attendance at the recommended postpartum visit, 3) utilization of needed behavioral health services, 4) occurrence of severe maternal morbidity, and 5) emergency department utilization among mothers who delivered in WI between 2011 and 2019.
Methods: This study leverages the existing “Big Data for Little Kids” (“BD4LK,” PI: Ehrenthal, Berger) data set, which links birth records and Medicaid claims data from all Medicaid-covered WI births from 2011 through 2019, including claims for antenatal and up to one year postpartum (total N = 571,219). We developed claims-based measures for each maternal outcome and will construct logistic regression models to predict the likelihood of each outcome based on exposure to PNCC services.
Expected Findings: Early tabulations suggest a meaningful association between PNCC exposure and maternal health outcomes. We expect final regression models to demonstrate that PNCC has strong associations to proximal maternal health outcomes including utilization of care.
Conclusions: Traditional measures of PNCC effectiveness, such as preterm birth and low birth weight, do not holistically capture the impact of these programs. This study is one of the first to evaluate proximal and mother-focused outcomes and will be used to inform policy and practice changes that will ultimately strengthen the program’s impact.