A Statewide Medicaid Enhanced Prenatal Care Program

Roman, LeeAnne; Raffo, Jennifer E.; Zhu, Qi; Meghea, Cristian

doi:10.1001/jamapediatrics.2013.4347

Cited by 78 publications

(62 citation statements)

References 52 publications

(47 reference statements)

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“…Early enrollment and the dosage of services have been shown to be important components of EPC programs, including MIHP. [15][16][17][18] We previously found that participation in MIHP improved health care utilization for mothers and infants and that early prenatal program enrollment and screening and a dosage of MIHP services reduced the risk of prematurity and low birth weight. 16,18 We tested the hypothesis that participation in MIHP reduced the risk of infant death.…”

Section: What This Study Addsmentioning

confidence: 99%

“…[15][16][17][18] We previously found that participation in MIHP improved health care utilization for mothers and infants and that early prenatal program enrollment and screening and a dosage of MIHP services reduced the risk of prematurity and low birth weight. 16,18 We tested the hypothesis that participation in MIHP reduced the risk of infant death. The large study population allowed for analyses by race, relevant due to the large disparities in birth outcomes and infant mortality (whites 5/1000 versus blacks 12/1000), and separate neonatal and postneonatal analyses, important because causes and potential mechanisms of program effect may be very different in the 2 periods.…”

Section: What This Study Addsmentioning

confidence: 99%

“…This allowed testing whether the more engaged clients experienced more favorable program effects, consistent with previous birth outcomes findings. 16 Another reason for excluding those with thirdtrimester MIHP enrollment from the second participation definition was that the pregnancies were more likely to be carried full-term, potentially biasing our analyses, as adverse birth outcomes are major determinants of infant death. 16 …”

Section: Mihp Participationmentioning

confidence: 99%

“…By using the first MIHP indicator, the reported propensity score analysis retained in the analyses 86% of the MIHP clients matched with nonparticipants, and 93% using the second MIHP indicator, similar rates as in our previous MIHP-matched evaluations. 16, 18 The analyses were separately estimated for both MIHP indicators, including propensity score estimations and matching.…”

Section: Analysesmentioning

confidence: 99%

“…The larger the hidden bias needed to invalidate the MIHP effects (available from the authors), the more likely the findings were to be robust. MIHP participation was shown to improve prenatal care and reduced risk of adverse birth outcomes, 16 all influencing infant mortality. 22 To investigate potential mechanisms through which MIHP may affect the risk of infant death, we adjusted our matched analysis for binary indicators of inadequate prenatal care, by using the Kotelchuck index (adequate/adequate plus versus intermediate/inadequate), 23 and of premature birth (,37 completed weeks) (Table 4).…”

Section: Analysesmentioning

confidence: 99%

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Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality

et al. 2015

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OBJECTIVE: To evaluate whether participation in a statewide enhanced prenatal and postnatal care program, the Maternal Infant Health Program (MIHP), reduced infant mortality risk.METHODS: Data included birth and death records, Medicaid claims, and program participation. The study population consisted of Medicaid-insured singleton infants born between January 1, 2009, and December 31, 2012, in Michigan (n = 248 059). The MIHP participants were propensity score-matched with nonparticipants based on demographics, previous pregnancies, socioeconomic status, and chronic disease. Infant mortality, neonatal mortality, and postneonatal mortality analyses were presented by race. CONCLUSIONS: A state Medicaid-sponsored population-based home-visitation program can be a successful approach to reduce mortality risk in a diverse, disadvantaged population. A likely mechanism is the reduction in the risk of adverse birth outcomes, consistent with previous findings on the effects of the program.

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Section: What This Study Addsmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Section: Mihp Participationmentioning

confidence: 99%

Section: Analysesmentioning

confidence: 99%

Section: Analysesmentioning

confidence: 99%

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Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality

et al. 2015

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Why Are Some Value-Based Programs Successful?

Anderson

Meiselbach

2023

JAMA Netw Open

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In their study, "Association of Participation in a Value-Based Insurance Design Program with Health Care Spending and Utilization," Zhang and Cowling 1 examine the association between a publicly sponsored value-based program in California targeted at increasing use of value-based care and health care utilization and costs. The program reduced patient copayments from $35 to $10 when the patient chose a primary care physician; it halved their annual deductible when they completed 5Open Access. This is an open access article distributed under the terms of the CC-BY License.

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Optimizing Public Policies for Pregnancy and Infant Outcomes

Lorch,

Peña,

Montoya-Williams

2024

JAMA Pediatr

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Pregnancy and infant health outcomes in the US continue to lag behind other countries with similar economic performance, with rates of infant and neonatal mortality and preterm birth typically 2 to 3 times higher than that of other high-income nations. 1 These adverse outcomes also differentially occur in patients by race, ethnicity, socioeconomic status, or rural vs urban residence. 2,3 As a result, there have been myriad programs and policies enacted on the state or local levels to address, and hopefully improve, the ultimate health of pregnant patients, newborns, and infants. Unfortunately, there is little information to help guide policymakers, advocates, or clinicians on the population health impact of such programs. The article by Chang et al 4 provides some evidence that state-level policies may influence pregnancy and newborn outcomes. This study calculated yearly state and local government expenditures per person with low income in multiple social programs, including state refundable earned income tax credits, cash assistance, childcare assistance, housing and community development, and public health. They found that, for every increase of $1000 per person with low income, overall rates of preterm birth, defined as delivery of a live-born infant at a gestational age of less than 37 weeks, was decreased by 1.4%. This effect was larger in infants of Black mothers and for expenditures in cash assistance, housing, and community development. Such research suggests that public policies on social programs may have short-and long-term impacts on infant health and may impact specific infant populations to a greater degree.However, this work also highlights the real challenges in developing and analyzing the effects of specific policies for pregnant people and their infants. The first issue is how to analyze such policies. Since it is extremely uncommon and often impossible to perform a randomized study of public policies, researchers are left with 2 primary methods to perform such analyses. The first is a difference-in-difference method, where states or regions that implement a policy are compared with states that did not, examining the change in the difference in outcomes between these groups after the policy is implemented. This method controls for both secular trends in outcomes and characteristics of the states or regions that do not change around the time of the policy implementation. Although this is a gold standard method of testing the effect of a policy, such work typically only studies 1 or a few states that implemented a specific policy; requires detailed data at the patient level, which can be challenging to obtain; and must pass multiple assumptions for the change in outcomes to be attributed to the policy change. 5

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A Statewide Medicaid Enhanced Prenatal Care Program

Abstract: Participation in MIHP reduced the risk for adverse birth outcomes in a diverse, disadvantaged population. The study adds to the evidence base for enhanced prenatal care home visiting programs and informs state and federal investments.

Cited by 78 publications

References 52 publications

Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality

Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality

Why Are Some Value-Based Programs Successful?

Optimizing Public Policies for Pregnancy and Infant Outcomes

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