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APHA Scientific Session and Event Listing

Heriberto A. Marín, PhD, Institute of Health Services Research of Puerto Rico, University of Puerto Rico, School of Public Health, PO Box 365067, San Juan, PR 00936-5067, 787-758-2525 x1423, hmarin@rcm.upr.edu

I. Objectives The objective of this study is to asses the effect of Medicaid managed care (MMC) on the access, initiation, utilization, and adequacy of prenatal care services during the implementation period of the health care reform in Puerto Rico from 1995 to 2000. II. Methodology The population in this study is all the infants born alive and their mothers in Puerto Rico from the year 1995 to 2000. The dependent variables are the following: use and no use of prenatal care , when the initial care occurred ,the number of visits for prenatal care,and the adequacy of care. The most important independent variable in our study is what type of health insurance the mother had during pregnancy. This variable is divided in four categories: those who had private health insurance, those with traditional Medicaid, those with Medicaid managed care (MMC), and those uninsured. III. Results First, after adjusting for confounders and selection bias MMC had a positive and significant effect on the amount and adequacy of prenatal care compared to those under traditional Medicaid. But, second, after adjusting for confounders and selection bias MMC did not improve acces os the timely initiation of care compared to traditional Medicaid. However, MMC was never able to achieved the levels of access, initiation, frequency, and adequacy of pregnant women with private insurance. IV. Conclussion Medicaid managed care in Puerto Rico was able to increase the amount and adequacy of prenatal care received by the Medicaid population to that of the private sector.

Learning Objectives:

• To discuss the implications of moving the medicaid population under a medicaid managed care program in terms of prenatal care and birth outcomes.

Keywords: Medicaid Managed Care, Infant Health

Presenting author's disclosure statement:

Not Answered