Does Medicaid managed care impact obstetrical care and birth outcomes?

A new study shows that among a set of disadvantaged women, Medicaid managed care reduces the women's access to high-quality hospital services during pregnancy and delivery and was associated with worse birth outcomes, worse prenatal care, and a higher risk of inappropriate gestational weight gain. The specific results and their implications are reported in a study published in Journal of Women's Health.

Ji Yan, Ph.D., Appalachian State University, Boone, NC, was the author of the article entitled "The Impact of Medicaid Managed Care on Obstetrical Care and Birth Outcomes: A Case Study." Dr. Yan based his findings on a dataset of disadvantaged women who had singleton births over a 10-year period, resulting in more than 78,300 mother-infant observations. The Medicaid managed care program under which these women received health care achieved cost savings by reducing the use of some high-tech obstetrical services and limiting access to high-quality hospital services. There was a price to pay, however, in maternal health care utilization and infant well-being.

Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health and Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, states: "This study emphasizes the need to be cautious in designing and implementing lower cost managed care programs for low-income obstetrical patients, as it demonstrates the possible negative outcomes for both mothers and their infants."