Racial and ethnic disparities in Medicaid expenditures for infants in North Carolina

Maternity Care Coordination was established in North Carolina (NC) as a component of Medicaid's prenatal care services. This study explores the racial and ethnic disparities in 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. 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). The number of infant diagnoses significantly predicts Medicaid expenditures above the mean costs for NC for infant claims (OR=3.890; CI: 3.584,4.221). Black (non-Hispanic) and Asian/Pacific Islander race/ethnicities significantly decrease the odds of having Medicaid expenditures exceed the mean for infant claims [OR=0.827; CI(0.749,0.913)] and [OR=0.439;CI: (0.245,0.785)], respectively; although, both ethnic groups are more likely to live in urban areas, (71% of blacks and 82% or API live in urban areas) and have infants with at least two diagnoses at birth. These results suggest that race, county type and the division of perinatal care regions for maternity care coordination may influence provision and utilization of Medicaid infant services. Furthermore, these results suggest that there are disparities in Medicaid costs for infants born to black and Asian/Pacific Islander mothers.