Preserving the Momentum to Extend Postpartum Medicaid Coverage

Eckert, Emily

doi:10.1016/j.whi.2020.07.006

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…These changes require significant efforts on the policy side, such as recent efforts to expand Medicaid coverage to 1 year postpartum. 19 However, change is also required on a local level, as providers identified areas in which both providers and patients require additional support. This support may come in the form of administrative assistance, structural changes in clinic flow, support for care coordination, and increased access to educational resources for all parties.…”

Section: Discussionmentioning

confidence: 99%

Provider Perspectives on Barriers and Facilitators to Postpartum Care for Low-Income Individuals

Ruderman

Dahl

Williams

et al. 2021

Women's Health Reports

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Background: Recent paradigm shifts in postpartum care have conceptualized the ''fourth trimester'' as a critical transitional period requiring tailored, ongoing health care. However, this concept presents challenges for providers, especially in low-resource settings. Our objective was to understand providers' perspectives on challenges in postpartum care to highlight strategies for optimizing care. Methods: Focus groups were conducted using a semistructured interview guide to elicit perspectives on barriers and facilitators to postpartum care. Participants included physicians, nurses, and social workers who care for lowincome postpartum individuals. Interviews explored the provider experience of postpartum care, with a focus on barriers experienced by patients and providers, and tools for maintaining engagement. Analysis was performed using the constant comparative method and framed by the Social Ecological Model. Results: Participants (N = 26) all acknowledged the importance of the ''fourth trimester'' but identified multiple barriers to providing optimal postpartum care. Challenges providers perceived for patients and those they perceived for themselves often overlapped, including difficulty with appointment scheduling, insurance limitations, lack of provider continuity, and knowledge gaps. Providers identified ease of referrals to specialists, access to tangible services (e.g., contraception), and enhanced care coordination (e.g., patient navigation) as potential facilitators of improved postpartum care. Conclusions: Obstetric providers recognize the importance of postpartum care yet highlighted significant systems-and patient-based barriers to achieving optimal care. The development and implementation of postpartum care delivery system redesign, such as the use of patient navigators to improve health care utilization and resource attainment, may enhance care during this critical time. Clinical Trial No.: NCT03922334.

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Section: Discussionmentioning

confidence: 99%

Provider Perspectives on Barriers and Facilitators to Postpartum Care for Low-Income Individuals

Ruderman

Dahl

Williams

et al. 2021

Women's Health Reports

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“…16 Many state-level Maternal Mortality Review Committees including Texas, Arizona, Georgia, and Maryland recommend extending Medicaid coverage for pregnant women for up to a year postdelivery. 17 Nurse advocacy on this policy issue is identified as a priority legislative initiative for 2022 by the Association of Women' s Health, Obstetric and Neonatal Nurses (AWHONN). 18 Both the American College of Nurse-Midwives (ACNM) and the American College of Obstetricians & Gynecologists (ACOG) strongly endorse this expansion.…”

Section: Common Causes Of Pregnancy-related Deaths In the Usmentioning

confidence: 99%

“…All states are mandated to provide Medicaid coverage for pregnant women with incomes below 138% of the federal poverty level, but this coverage frequently ends 60 days after giving birth 16. Many state-level Maternal Mortality Review Committees including Texas, Arizona, Georgia, and Maryland recommend extending Medicaid coverage for pregnant women for up to a year postdelivery 17. Nurse advocacy on this policy issue is identified as a priority legislative initiative for 2022 by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) 18.…”

Section: Nursing Considerationsmentioning

confidence: 99%

Rising US pregnancy-related deaths

Heavey¹

2022

Nursing

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“…Recent research has focused on insurance rates during the postpartum period for mothers and the association with maternal morbidity and mortality 2 ; however, policies that contribute to postpartum coverage cliffs (eg, Medicaid eligibility limits) can also affect mothers at other stages in life. 3 , 4 , 5 Using data from the American Community Survey (ACS), the present analysis tracks maternal insurance coverage status as children age from infancy to adulthood. We find that uninsurance rates increase for mothers at 2 points in their child’s life: (1) when the child is younger than 1 year and (2) when the child turns 18 years old.…”

Section: Introductionmentioning

confidence: 99%