The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68461

M. Beth Benedict, DrPH, JD, Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, 7500 Security Blvd., Mail Stop: C3-19-07, Baltimore, MD 21244-1850, 410-786-7724, bbenedict@cms.hhs.gov and Norma I. Gavin, PhD, Health, Social and Economics Research, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709.

A CMS-sponsored study comparing pregnant women who were enrolled in the Medicaid categories of low-income or poverty, and pregnant women enrolled under the disability categories, in four racially/culturally diverse states. Across the study states, the barriers to access to care were lower for the pregnant women who are enrolled in a Medicaid disability category rather than a low-income or poverty category because they tended to be enrolled at least six to nine months before delivery. However, the disabled tended to have inadequate prenatal care according to national guidelines, to have more pregnancy complications, and to have a cesarean section. The disabled pregnant women who were Black tended to have more health risk behaviors, to be teenagers or over 35 years of age with less than a high school educational level, to have emergency room visits and hospitalizations before and after delivery, to experience more adverse maternal and newborn outcomes, and to be more costly to Medicaid than other groups. The study methodology included multivariate analyses and other statistics aimed to explain the sources of these higher adverse outcomes. The findings will be presented with emphasis on the impacts of enrollment category, timing and duration of enrollment, and insights for providing quality care to beneficiaries whose health care needs include both the disabled and the maternal prenatal care programs in Medicaid. Differences in coverage, services, and program expenditures will be discussed.

Learning Objectives:

At the conclusion of this presentation, the participants will be able to:
• Discuss the need to look beyond access as defined by Medicaid enrollment, to other factors to assure that disabled pregnant women receive the needed pregnancy-related care.
• Describe key factors that show how the pregnancy-related needs of the Medicaid enrolled disabled and non-disabled pregnant women differ, and result in increased adverse maternal and newborn outcomes.
• Medicaid program administration and management strategies to bring together the benefits of the disability programs with the maternal programs to provide quality care aimed to improve outcomes, and to minimize use of high cost emergency rooms visits and hospitalizations before and after the delivery stay.

Keywords: Access and Services, Medicaid

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: not applicable
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.