Variable Uptake of Medicaid-Covered Prenatal Care Coordination: The Relevance of Treatment Level and Service Context

This study examines the reach and uptake of Wisconsin ’s Prenatal Care Coordination (PNCC) program among Medicaid-covered, residence occurrence live births between 2008 and 2012. Data come from the Big Data for Little Kids project, which harmonizes birth records with multiple state administrative sources. Logistic regression analyses measured the ass ociation between county- and maternal-level factors and the odds of any PNCC use and the odds of PNCC uptake (>  2 PNCC services among those assessed). Among identified Medicaid-covered births (n = 136,057), approximately 24% (n = 33,249) received any PNCC and 17% (n = 22,680) took up PNCC services. Any PNCC receipt and PNCC uptake varied substantially across counties. A higher county assess ment rate was associated with a higher odds of individual PNCC assessment but negatively associated with uptake. Mothers reporting clinical risk factors such as chronic hypertension and previous preterm birth were more likely to be assessed for PNCC and, once assessed, more likely to received contin ued PNCC services. However, most mothers reporting clinical risk factors were not assessed for services. Estimates of care coordination’s effects on birth outcomes should account for service context and the treatment level into which participants select.

Source: Journal of Community Health - January 11, 2019 Category: International Medicine & Public Health Source Type: research