Strategies to Improve Access to LARC: Focus on Advocacy for Appropriate Reimbursement

Expanding access to the most effective reversible contraceptive methods available, the contraceptive implant and intrauterine devices, also known as long-acting reversible contraception (LARC), has been offered as a strategy for reducing the continued high rate of unintended pregnancies in the U.S. Evidence shows that most women are eligible to use LARC methods, but high up-front costs for these devices in comparison to other reversible contraceptive methods has been one barrier to increased uptake. Under the Affordable Care Act’s contraceptive coverage rule, millions of women now have improved access to LARC methods. However, the continued high cost of these methods, combined with difficulties some providers have in receiving appropriate reimbursement for provision of these devices, can still result in barriers to LARC access. We explored these reimbursement barriers to LARC through a series of key informant interviews and a summit meeting of leaders in the field, gathered replicable strategies for improvement, and provided recommendations for continued advocacy to improve LARC access through appropriate reimbursement for services and supplies. Successful efforts in several states to improve Medicaid reimbursement policies for the provision of LARC methods immediately postpartum provide useful case studies of best practices in this type of public health advocacy.