The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity

Summary

The goal of this study is to learn about the effects of structural inventions, such as equity-focused Medicaid polices, on severe maternal morbidity (SMM) and mortality and maternal health. The main questions it aims to answer are:

1. What is the effect of Medicaid healthcare quality interventions on SMM?
2. What is the effect of Medicaid healthcare quality interventions + doula care?
3. What are Medicaid beneficiaries' experiences in receiving services and the potential impact of integration of doula services and equity practices?

Participants will be asked to describe experiences as a result of structural interventions and focused Medicaid policies.

Conditions

• Severe Maternal Morbidity
• Maternal Death

Interventions

BEHAVIORAL

Medicaid healthcare quality interventions (equity payment and obstetric bundled payment)

This study has two components, with the first component being examined in Aim 1 and the first and second components being examine in aim 2. 1\) health equity incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care and well-child visits among Black beneficiaries. The equity-focused obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among Black beneficiaries

BEHAVIORAL

Doula

This study has two components, with the first component being examined in Aim 1 and the first and second components being examine in aim 2. 1. health equity incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care and well-child visits among Black beneficiaries. The equity-focused obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among Black beneficiaries. 2. care intervention by coverage of doula services for all Medicaid beneficiaries across Pennsylvania.

BEHAVIORAL

Standard Care

Participants receive standard care without quality interventions or doula care

Sponsors & Collaborators

• National Institute of Nursing Research (NINR)

  collaborator NIH

• University of Pittsburgh

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

FACTORIAL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-01-03

Primary Completion

2027-06-30

Completion

2027-06-30

Countries

• United States

Study Locations