Describing costs of public-funded high risk reproductive health programs for indigent African American women in Mississippi

Improving health status of Mississippi (MS) families, while controlling health care costs, is a high concern in the state. The challenge for MS is to identify critical strengths among publicly funded interventions and build upon those that improve health while also realizing social and financial progress for the state. The specific aims of this study were to quantify costs related to delivery of case-managed reproductive health services for high risk Mississippi women and to describe the outcomes of two programs designed to improve maternal and infant health before and during pregnancy. The study population included adult, African American indigent women (n = 80) enrolled in one of two case management programs between March 2009 and February 2010. Data were extracted from program and patient files. Variables of interest included demographics, program enrollment, and improved infant and maternal health. Costs included Medicaid or program expenses for salaries, travel, supplies, direct care services, and enabling expenses. The sample included 40 participants each from the PHRM and IPC programs with average ages of 26 and 24 years, respectively. Less than half (n=18) of PHRM clients and nearly all (n=38) of the IPC clients achieved the desired outcome. The findings describe two fundable programs with differing outcomes and unpredictable success. Literature findings suggest that prevention is the best strategy for increasing infants' quantity and quality of life. Secondary strategies should include comprehensive, case managed services, such as the programs in this study, with the focus being risk reduction among the most vulnerable population groups.