Medicaid infant claims, costs and regional characteristics for women receiving maternity care coordination in North Carolina

Maternity Care Coordination was established in North Carolina (NC) as a component of Medicaid's prenatal care services. The effects of regional characteristics such as type of county and perinatal care regions could potentially influence the utilization of services by Medicaid eligible women. This study explores the associations between NC's perinatal care regions and counties and the number and costs of Medicaid infant claims within the first year of the infant's life. Health services data, including Medicaid claims for Maternity Care Coordination and Medicaid infant claims and amount paid within the first year of life were linked with birth certificates for 2004. Chi-square and logistic regression analyses were conducted to determine associations between county of residence, perinatal care regions and Medicaid infant claims and costs. Preliminary results show associations between type of county and total number of infant claims and amounts paid by Medicaid (p<0.0001) as well as perinatal region and total number of infant claims and amount paid by Medicaid (p<0.0001). Infants born in urban counties were more likely to have greater Medicaid costs (OR=1.54; CI=1.45,1.64) and fewer infant claims (OR=0.87; CI=0.84, 0.90) in the first 60 days of life compared to those in rural counties. Women living in urban counties were more likely to have three infant diagnoses compared to women living in rural counties (OR=1.33; CI=1.27, 1.40). These results suggest that county type and the division of perinatal care regions for maternity care coordination may influence provision and utilization of Medicaid infant services.